MKSAP 19 "Quiz Me!" Question

Test your medical knowledge each month with questions from The Medical Knowledge Self-Assessment Program® (MKSAP).


For over 50 years, the Medical Knowledge Self-Assessment Program (MKSAP) has been the most trusted resource in continuous learning for internal medicine physicians and residents. The tradition continues with MKSAP 19.

MKSAP 19, released in early 2022, is available in several flexible formats, allowing you to choose the format that best fits your lifestyle. Each format includes 12 syllabus sections and 1,200 associated deep-learning self-assessment questions.

Learn about the new features in MKSAP 19, as well as pricing and release dates.


A 68-year-old man is evaluated in the emergency department for gastrointestinal bleeding. He reports a 3-day history of dark stools and upper abdominal pain but is otherwise asymptomatic. Medical history is significant for coronary artery disease for which he underwent drug-eluting stent placement 7 months ago. Medications are metoprolol, atorvastatin, aspirin, and clopidogrel.

On physical examination, blood pressure is 110/80 mm Hg and pulse rate is 100/min; other vital signs are normal. Abdominal examination reveals midepigastric tenderness. Rectal examination reveals guaiac-positive stool.

Laboratory studies show a hemoglobin level of 10.6 g/dL (106 g/L) and platelet count of 150,000/μL (150 × 109/L). Activated partial thromboplastin time and prothrombin time are normal. Appropriate fluid resuscitation is initiated along with a proton pump inhibitor. Endoscopy is planned. Cardiology consultation is obtained.

Which of the following is the most appropriate antiplatelet management?

A: Discontinue clopidogrel
B: Discontinue clopidogrel and aspirin
C: Initiate platelet transfusion
D: No change in management

Answer and Critique

Back to the November 2022, Issue 2 of ACP IMpact