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MKSAP quiz: medical history of mitral regurgitation

A 45-year-old man undergoes a pre-employment physical examination. Medical history is notable for aortic coarctation with an end-to-end anastomosis performed at 4 years of age. During a physical exam, a grade 2/6 mid-peaking systolic murmur is noted at the second right intercostal space. What is the most likely cause of this patient's systolic murmur?
https://immattersacp.org/weekly/archives/2021/06/29/3.htm
29 Jun 2021

MKSAP Quiz: Right-upper-quadrant abdominal discomfort

A 36-year-old woman is evaluated for a 3-day history of constant right-upper-quadrant abdominal discomfort and abdominal distention. She has no significant medical history. Following a physical exam and lab tests, what is the most appropriate diagnostic test to perform next?
https://immattersacp.org/weekly/archives/2021/10/19/3.htm
19 Oct 2021

MKSAP quiz: Severe anxiety and repetitive behavior

A 25-year-old man evaluated during a new patient visit is concerned about his ability to arrive on time at a new job because every morning before leaving his apartment, he feels compelled to perform multiple checks to ensure that all electronic devices are turned off and all windows and doors are locked. What is the most appropriate management?
https://immattersacp.org/weekly/archives/2021/08/03/3.htm
3 Aug 2021

MKSAP Quiz: 1-year history of weight gain, easy bruising

A 52-year-old woman is evaluated for a 1-year history of a 6.8-kg (15-lb) weight gain, easy bruising, hypertension, and worsening diabetes control. Lab studies reveal hypercortisolism. What is the most likely cause?
https://immattersacp.org/weekly/archives/2021/07/20/3.htm
20 Jul 2021

MKSAP Quiz: Several months of itchy, scaly feet

A 50-year-old man is evaluated for a several-month history of itchy, scaly feet. It has persisted despite the application of a moisturizing lotion. A physical exam reveals erythematous scaly patches on the sides of the feet and maceration between toes. What is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2021/07/13/3.htm
13 Jul 2021

MKSAP Quiz: Establishing care for HIV

A 31-year-old man arrives to establish care for newly diagnosed HIV infection. He is asymptomatic. Medical history is otherwise noncontributory, and he takes no medications. Following a physical exam and review of lab studies, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2021/08/17/3.htm
17 Aug 2021

MKSAP Quiz: Follow-up evaluation for nephrolithiasis

A 61-year-old woman has a follow-up evaluation for the incidental discovery of several hypodense lesions in both lobes of her liver and a 2.5-cm mesenteric mass during CT imaging for nephrolithiasis. She has fully recovered from the nephrolithiasis and now feels entirely well. Following a physical exam and lab studies, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2021/08/10/3.htm
10 Aug 2021

MKSAP Quiz: Evaluation for pneumonia

An 81-year-old man is evaluated in the hospital for pneumonia. Following a physical exam and CT scan of the chest, what pleural fluid test is most appropriate in directing therapy?
https://immattersacp.org/weekly/archives/2023/10/17/3.htm
17 Oct 2023

MKSAP Quiz: A 3-year history of decline in cognition

A 60-year-old man is evaluated for a 3-year history of gradual, progressive decline in his cognition, behavior, and motor skills. Following a physical exam, MRI, and neuropsychological testing, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2021/09/28/3.htm
28 Sep 2021

MKSAP Quiz: Pruritic rash on elbows and knees

A 27-year-old man is evaluated for a pruritic rash on his elbows and knees of 3 years' duration. Celiac disease was diagnosed 7 months ago. He started a gluten-free diet, and the diarrhea resolved but the rash has persisted. Following a physical exam and other tests, what is the most appropriate management?
https://immattersacp.org/archives/2023/07/mksap-quiz-pruritic-rash-on-elbows-and-knees.htm
1 Jul 2023

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