Test your medical knowledge each month with questions from The Medical Knowledge Self-Assessment Program® (MKSAP).
MKSAP has been trusted by internists since 1967 as the best resource for updating knowledge. MKSAP 18, available in Complete, Digital, and Print packages, consists of 11 comprehensive text chapters with related multiple-choice questions. You'll find 1,200 completely new questions to help you identify learning gaps, stay current, and gain the knowledge you need to provide the best possible patient care. MKSAP 18's original and high-quality questions evolve out of case studies and patient scenarios based on the latest evidence.
For more information on MKSAP 18, or to order your copy, visit mksap18.acponline.org.
MKSAP 18 Q & A
An 85-year-old woman is evaluated for left knee pain of moderate intensity that occurs with ambulation and at night. Acetaminophen provides no relief. History is significant for coronary artery disease, hypertension, and stage 3 chronic kidney disease. Medications are aspirin, lisinopril, metoprolol, and vitamin D.
On physical examination, blood pressure is 152/88 mm Hg; other vital signs are normal. The left knee demonstrates crepitus and decreased passive range of motion; a small effusion is present, and there is no warmth or tenderness. Joint aspiration of the left knee shows a leukocyte count of 1100/µL (1.1 × 109/L).
Which of the following is the most appropriate treatment for long-term symptom control?
A: Intra-articular glucocorticoid injections
B: Low-dose prednisone
E: Topical diclofenac