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IM MKSAP EXAM QUESTIONS AND NSWRS
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IM MKSAP EXAM QUESTIONS AND NSWRS
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IM MKSAP EXAM QUESTIONS AND NSWRS50 yo F is seen following screening digital mammography. She is asymptomatic. Other
than her age and sex, she has no additional risk factors for breast cancer and no family
history of breast cancer. Mammogram report notes no suspicious lesions but indicates
that the breasts are heterogeneously dense. - Answers -No further testing
49 yo F is evaluated for a 3 year history of pelvic pain. An extensive eval has not found
a clearly defined or anatomic cause, and therapy has been targeted to general pain mgt
lately. She has been a willing participant in biofeedback - Answers -Oral medical
cannabis oil
66 yo M is evaluated for R posterior knee swelling that began 3 days ago. The knee is
not painful, unstable, warm, or red. A large bulge is visible on the posterior aspect of the
R knee. Crepitus of knee is noted bilaterally. - Answers -No treatment
56 yo F is evaluated during a wellness exam. Over the past 3 months, noticed a lack of
interest in sexual activity that has been occasionally distressing for her. - Answers -No
female sexual disorder
78 yo M is evaluated in the ED for a 1 day history of worsening dizziness. Describes the
dizziness as a room spinning sensation and notes that he has some accompanying
nausea and imbalance. Pt has difficulty with tandem walking and has vertical
nystagmus with EOM. - Answers -MRI of the brain
27 yo F is evaluated for help with weight loss. After a visit 3 months ago, she enrolled in
an online weight loss program and began a walking program. - Answers -Behavioral
therapy
45 yo M was hospitalized following a head on motor vehicle crash. On day 4, he
survived cardiac arrest but experienced anoxic brain injury. - Answers -Pt's previously
expressed wishes
23 yo F evaluated for depression as she prepares for discharge from the hospital from
hospice care. She as diagnosed with metastatic ovarian cancer 2 years ago. Most
appropriate treatment? - Answers -Methylphenidate
52 yo M evaluated for 2 day history of painless red eye, which began on the right side
and quickly spread to the left. Reports that his eyes have a thin mucopurulent discharge
and that eyelids are matted shut in the morning upon waking. Most appropriate
treatment? - Answers -Trimethoprim-polymyxin B ophthalmic drops
66 yo F evaluated during a f/u for a 5 year hx of chronic autoimmune pancreatitis. She
has constant, severe, aching, midabdominal pain that radiates to the back. Her only
, surgical option is a pancreaticojejunostomy, a procedure that she is not ready to accept.
- Answers -Prescribe naloxone and provide caregiver education on its use
60 yo M is evaluated for abdominal cramping and diarrhea that began after starting
ezetimibe. The pt has had persistently elevated LDL cholesterol levels while taking
maximally tolerated statin therapy - Answers -Add alirocumab
65 yo M is evaluated to establish care. He is interested in colorectal screening,
however, he adamantly refuses to undergo colon prep, and he does not want to modify
his diet for screening. Most appropriate screening test? - Answers -Fecal
immunochemical test
35 yo F is evaluated during a follow up visit for anxiety. Sx have been well controlled
with CBT and she has been drinking kava tea every morning. - Answers -Discontinue
kava tea
70 yo M is seen for a pre-operative medical evaluation before laminectomy for spinal
stenosis. Swims for 30 minutes every other day. ECG performed 2 years ago
demonstrated a left anterior fascicular block, several PAC, and sinus rhythm. Most
appropriate pre-operative cardiac testing for this pt? - Answers -ECG
44 yo M is evaluated for right medial elbow pain that began 2 months ago with a dull
ache and has gradually worsened. Pain is worse with elbow flexion, and his R 4th and
5th fingers are numb. - Answers -Ulnar nerve entrapment
63 yo F evaluated in ED after an unwitnessed syncopal event. She recalls feeling a
sensation of warmth and generalized weakness prior to the event. - Answers -
Orthostatic blood pressure measurement and electrocardiography
37 yo F evaluated for contraceptive advice. She is married and has a 1 year old child. Pt
describes the conception of this child as an "accident" - Answers -Progesterone-
containing intrauterine device
43 yo F evaluated during a f/u appt for obesity. She has been following a reduced-
calorie, low-fat diet and participating in a 45 minute aerobic exercise class 3 times
weekly for the past 6 months. - Answers -Liraglutide
37 yo M inquires about palliative medicine referral during a follow up visit after hospital
discharge. Most appropriate time for palliative medicine referral? - Answers -Now
51 yo F is evaluated during a routine follow up for DM. Her 10 year risk for
atherosclerotic cardiovascular disease is 11% - Answers -Low dose aspirin
37 yo F evaluated for a 6 year hx of difficulty initiating sleep and significant sleepiness.
She works as a RN and notes that daytime sleepiness is exacerbated when she works
several night shifts in a row at the hospital. - Answers -Two week sleep diary
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