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Dec 10, 2024 | 
immattersacp.org | Charlotte Huff |Gianna Melillo |ACP Internist
MKSAP Answer and Critique
The correct answer is A. Cystoscopy with retrograde pyelography. This content is available
to MKSAP subscribers as Question 95 in the Nephrology section. More information about MKSAP is available online.
Cystoscopy with retrograde pyelography (Option A) is the most appropriate management for this patient to assess for evidence of urothelial
tumor.
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Sep 9, 2024 | 
immattersacp.org | Gianna Melillo |Charlotte Huff |ACP Internist
https://immattersacp.org/weekly/archives/2024/09/10/4.htm I.M. Matters Weekly | Heart failure | September 10, 2024 Steroidal mineralocorticoid receptor antagonists (MRAs) (e.g., spironolactone and eplerenone) reduced risk for cardiovascular death or heart failure hospitalization in patients with heart failure and reduced ejection fraction (EF), while nonsteroidal MRAs (e.g., finerenone) seemed beneficial in those with mildly reduced or preserved EF, an individual-patient level meta-analysis...
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Sep 9, 2024 | 
immattersacp.org | Gianna Melillo |Charlotte Huff |ACP Internist
Vaginal estrogen, vaginal dehydroepiandrosterone (DHEA), oral ospemifene, and vaginal
moisturizers may improve genitourinary syndrome of menopause in the short term, a
systematic review reported.
Researchers compiled data from 46 unique randomized, controlled trials (RCTs) of the
four treatments in postmenopausal women with at least one symptom, such as dryness of the vulvar or vaginal area, urgency or pain with urination, pain
with intercourse, or decreased libido.
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Sep 2, 2024 | 
immattersacp.org | Gianna Melillo |Charlotte Huff |ACP Internist
MKSAP Answer and Critique
The correct answer is C. Start G-CSF at the time of chemotherapy. This content is
available to MKSAP subscribers as Question 13 in the Hematology section. More information about MKSAP is available online.
The patient should start granulocyte colony-stimulating factor (G-CSF) with his next
cycle of chemotherapy (Option C).
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Aug 31, 2024 | 
immattersacp.org | Gianna Melillo |Charlotte Huff |ACP Internist
A 77-year-old woman is hospitalized for intermittent recurrent chest pain. Her ECG
is shown.
The patient had a moderately severe ischemic stroke 2 years ago and has oxygen-dependent
COPD. Medications are aspirin, atorvastatin, and inhaled albuterol and tiotropium.
On physical examination, blood pressure is 145/85 mm Hg, pulse rate is 82/min, and
respiration rate is 18/min. Oxygen saturation is 90% on 2 L of oxygen by nasal cannula. BMI is 18.
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May 21, 2024 | 
immattersacp.org | Charlotte Huff |Janet Colwell |ACP Internist
A 56-year-old man is evaluated for erectile dysfunction that began insidiously 1 year
ago. He reports that his libido and mood are good. He is in a monogamous relationship
with his wife. He runs on a treadmill for 30 to 45 minutes three to four times weekly,
and he has no cardiovascular symptoms. The patient's medical history is also significant
for coronary artery bypass graft surgery 4 years ago, hyperlipidemia, and hypertension. Medications are metoprolol, losartan, aspirin, and atorvastatin.
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May 14, 2024 | 
immattersacp.org | Charlotte Huff |Janet Colwell |ACP Internist
MKSAP Answer and Critique
The correct answer is B. Exercise therapy. This content is available to MKSAP 19 subscribers
as Question 4 in the General Internal Medicine 1 section. More information about MKSAP is available online.
Exercise therapy (Option B) is the most appropriate treatment for this patient with chronic low back pain. Nonpharmacologic
treatment is recommended as first-line therapy for patients with acute (<4 weeks),
subacute (4-12 weeks), or chronic (>12 weeks) low back pain.
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Apr 30, 2024 | 
immattersacp.org | Charlotte Huff |Janet Colwell |ACP Internist
A 32-year-old woman is seen for follow-up evaluation of chronic anemia that has been
stable for at least the past 5 years. She has no history of transfusions. She had
one pregnancy at age 29 years, ending in intrauterine fetal demise in the early third
trimester. Her father has anemia. The patient is Chinese.
On physical examination, vital signs and the remainder of the physical examination
are normal.
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Apr 29, 2024 | 
immattersacp.org | Charlotte Huff |Janet Colwell |ACP Internist
A real-time, targeted, individualized electronic health record (EHR) alert resulted
in a numerically higher but not statistically significant increase in patients with
atherosclerotic cardiovascular disease receiving lipid lowering therapy intensification
compared with usual care, a study found.
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Mar 31, 2024 | 
immattersacp.org | Charlotte Huff |Janet Colwell |ACP Internist
A 29-year-old woman is evaluated for a 6-month history of acne that worsens during
menses. She has been using topical benzoyl peroxide wash and topical tretinoin cream,
but there has been no improvement. She reports no hirsutism or virilization symptoms. Menses are regular. She has no other medical problems and takes no additional medications.
Skin findings are shown.
No features of hyperandrogenism are noted.
Which of the following is the most appropriate management?
A.
