Current Medical Diagnosis and Treatment
2026 Exam Questions and Verified Answers |
High-Yield Clinical Study Guide for Medical
Success
CURRENT MEDICAL DIAGNOSIS AND TREATMENT 2026
High-Yield Clinical Exam Questions & Verified Answers
• This high-yield clinical study guide covers 200 exam-style MCQs drawn from the
full spectrum of Current Medical Diagnosis and Treatment 2026, designed to
sharpen diagnostic reasoning and reinforce treatment protocols for medical
success.
• Each question features five options (A–E), a clearly highlighted correct answer
with EXPERT RATIONALE, making this an efficient active-recall tool — best used
after reading each CMDT chapter, then revisiting missed questions for spaced
repetition review.
1. A 58-year-old man presents with crushing substernal chest pain radiating to
the left arm for 45 minutes. ECG shows ST-segment elevation in leads II, III,
and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Left main coronary artery
D. Right coronary artery
E. Posterior descending artery
Correct Answer: D. Right coronary artery
,EXPERT RATIONALE: ST elevation in leads II, III, and aVF indicates an inferior STEMI. The
right coronary artery (RCA) supplies the inferior wall of the left ventricle in approximately
85% of individuals (right-dominant circulation). Immediate reperfusion therapy is
indicated.
2. A 45-year-old woman with a history of hypertension presents with a blood
pressure of 180/110 mmHg and a new severe headache. Her creatinine is 2.8
mg/dL (baseline 1.0). Urinalysis shows red cell casts. What is the most
appropriate next step?
A. Oral amlodipine and outpatient follow-up
B. Observation for 24 hours
C. IV labetalol and urgent admission
D. Thiazide diuretic initiation
E. Renal biopsy before treatment
Correct Answer: C. IV labetalol and urgent admission
EXPERT RATIONALE: This presentation is consistent with hypertensive emergency with
end-organ damage (acute kidney injury, hypertensive nephrosclerosis). IV
antihypertensives such as labetalol or nicardipine are first-line. Blood pressure should
be reduced by no more than 25% in the first hour.
3. A 32-year-old pregnant woman at 28 weeks gestation presents with right
upper quadrant pain, elevated liver enzymes, thrombocytopenia, and
hemolysis. What is the diagnosis?
A. Acute fatty liver of pregnancy
B. Intrahepatic cholestasis of pregnancy
C. HELLP syndrome
D. Preeclampsia without severe features
,E. Viral hepatitis B exacerbation
Correct Answer: C. HELLP syndrome
EXPERT RATIONALE: HELLP syndrome is characterized by Hemolysis, Elevated Liver
enzymes, and Low Platelets. It is a severe variant of preeclampsia requiring urgent
delivery regardless of gestational age when severe. Management includes magnesium
sulfate for seizure prophylaxis.
4. A 67-year-old man with a 40-pack-year smoking history presents with
hemoptysis, weight loss, and a central mass on chest X-ray. Biopsy shows
large cells with abundant cytoplasm and prominent nucleoli. What is the
most likely diagnosis?
A. Small cell lung carcinoma
B. Adenocarcinoma of the lung
C. Squamous cell carcinoma of the lung
D. Large cell carcinoma of the lung
E. Carcinoid tumor
Correct Answer: D. Large cell carcinoma of the lung
EXPERT RATIONALE: Large cell carcinoma is an undifferentiated non-small cell lung
cancer characterized by large cells with abundant cytoplasm and prominent nucleoli on
biopsy. It tends to arise peripherally but can be central. It lacks the features of
squamous (keratin pearls) or adenocarcinoma (glandular structures).
5. A 25-year-old woman presents with episodic palpitations, diaphoresis, and
headaches. Her blood pressure is 190/105 mmHg during an episode. 24-hour
urine shows elevated metanephrines and catecholamines. What is the most
appropriate initial treatment?
A. Beta-blocker monotherapy
B. Surgical adrenalectomy without medical preparation
, C. Alpha-blockade with phenoxybenzamine followed by beta-blockade
D. Calcium channel blocker only
E. ACE inhibitor and lifestyle modification
Correct Answer: C. Alpha-blockade with phenoxybenzamine followed by
beta-blockade
EXPERT RATIONALE: Pheochromocytoma requires alpha-blockade FIRST
(phenoxybenzamine or doxazosin) before beta-blockers to prevent unopposed alpha-
stimulation causing hypertensive crisis. Beta-blockers alone can precipitate a severe
hypertensive emergency. Surgery is definitive after adequate medical preparation.
6. A 55-year-old man with type 2 diabetes presents with progressive
proteinuria and a GFR of 35 mL/min/1.73m². BP is 145/90 mmHg. What is the
most appropriate pharmacologic strategy?
A. Thiazide diuretic alone
B. ACE inhibitor or ARB with target BP <130/80 mmHg
C. Beta-blocker for cardiovascular protection only
D. Calcium channel blocker without RAAS blockade
E. Sodium restriction alone
Correct Answer: B. ACE inhibitor or ARB with target BP <130/80 mmHg
EXPERT RATIONALE: ACE inhibitors and ARBs provide renoprotection in diabetic
nephropathy beyond blood pressure lowering by reducing intraglomerular pressure and
proteinuria. Target BP per CMDT 2026 guidelines is <130/80 mmHg in diabetics with
CKD. They are first-line regardless of baseline BP.
7. A 70-year-old woman presents with acute onset confusion, fever of 39.2°C,
nuchal rigidity, and photophobia. CSF analysis shows glucose 30 mg/dL (serum
glucose 110), protein 180 mg/dL, and WBC 1200 cells/µL (90% neutrophils).
What is the most appropriate initial management?
2026 Exam Questions and Verified Answers |
High-Yield Clinical Study Guide for Medical
Success
CURRENT MEDICAL DIAGNOSIS AND TREATMENT 2026
High-Yield Clinical Exam Questions & Verified Answers
• This high-yield clinical study guide covers 200 exam-style MCQs drawn from the
full spectrum of Current Medical Diagnosis and Treatment 2026, designed to
sharpen diagnostic reasoning and reinforce treatment protocols for medical
success.
• Each question features five options (A–E), a clearly highlighted correct answer
with EXPERT RATIONALE, making this an efficient active-recall tool — best used
after reading each CMDT chapter, then revisiting missed questions for spaced
repetition review.
1. A 58-year-old man presents with crushing substernal chest pain radiating to
the left arm for 45 minutes. ECG shows ST-segment elevation in leads II, III,
and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Left main coronary artery
D. Right coronary artery
E. Posterior descending artery
Correct Answer: D. Right coronary artery
,EXPERT RATIONALE: ST elevation in leads II, III, and aVF indicates an inferior STEMI. The
right coronary artery (RCA) supplies the inferior wall of the left ventricle in approximately
85% of individuals (right-dominant circulation). Immediate reperfusion therapy is
indicated.
2. A 45-year-old woman with a history of hypertension presents with a blood
pressure of 180/110 mmHg and a new severe headache. Her creatinine is 2.8
mg/dL (baseline 1.0). Urinalysis shows red cell casts. What is the most
appropriate next step?
A. Oral amlodipine and outpatient follow-up
B. Observation for 24 hours
C. IV labetalol and urgent admission
D. Thiazide diuretic initiation
E. Renal biopsy before treatment
Correct Answer: C. IV labetalol and urgent admission
EXPERT RATIONALE: This presentation is consistent with hypertensive emergency with
end-organ damage (acute kidney injury, hypertensive nephrosclerosis). IV
antihypertensives such as labetalol or nicardipine are first-line. Blood pressure should
be reduced by no more than 25% in the first hour.
3. A 32-year-old pregnant woman at 28 weeks gestation presents with right
upper quadrant pain, elevated liver enzymes, thrombocytopenia, and
hemolysis. What is the diagnosis?
A. Acute fatty liver of pregnancy
B. Intrahepatic cholestasis of pregnancy
C. HELLP syndrome
D. Preeclampsia without severe features
,E. Viral hepatitis B exacerbation
Correct Answer: C. HELLP syndrome
EXPERT RATIONALE: HELLP syndrome is characterized by Hemolysis, Elevated Liver
enzymes, and Low Platelets. It is a severe variant of preeclampsia requiring urgent
delivery regardless of gestational age when severe. Management includes magnesium
sulfate for seizure prophylaxis.
4. A 67-year-old man with a 40-pack-year smoking history presents with
hemoptysis, weight loss, and a central mass on chest X-ray. Biopsy shows
large cells with abundant cytoplasm and prominent nucleoli. What is the
most likely diagnosis?
A. Small cell lung carcinoma
B. Adenocarcinoma of the lung
C. Squamous cell carcinoma of the lung
D. Large cell carcinoma of the lung
E. Carcinoid tumor
Correct Answer: D. Large cell carcinoma of the lung
EXPERT RATIONALE: Large cell carcinoma is an undifferentiated non-small cell lung
cancer characterized by large cells with abundant cytoplasm and prominent nucleoli on
biopsy. It tends to arise peripherally but can be central. It lacks the features of
squamous (keratin pearls) or adenocarcinoma (glandular structures).
5. A 25-year-old woman presents with episodic palpitations, diaphoresis, and
headaches. Her blood pressure is 190/105 mmHg during an episode. 24-hour
urine shows elevated metanephrines and catecholamines. What is the most
appropriate initial treatment?
A. Beta-blocker monotherapy
B. Surgical adrenalectomy without medical preparation
, C. Alpha-blockade with phenoxybenzamine followed by beta-blockade
D. Calcium channel blocker only
E. ACE inhibitor and lifestyle modification
Correct Answer: C. Alpha-blockade with phenoxybenzamine followed by
beta-blockade
EXPERT RATIONALE: Pheochromocytoma requires alpha-blockade FIRST
(phenoxybenzamine or doxazosin) before beta-blockers to prevent unopposed alpha-
stimulation causing hypertensive crisis. Beta-blockers alone can precipitate a severe
hypertensive emergency. Surgery is definitive after adequate medical preparation.
6. A 55-year-old man with type 2 diabetes presents with progressive
proteinuria and a GFR of 35 mL/min/1.73m². BP is 145/90 mmHg. What is the
most appropriate pharmacologic strategy?
A. Thiazide diuretic alone
B. ACE inhibitor or ARB with target BP <130/80 mmHg
C. Beta-blocker for cardiovascular protection only
D. Calcium channel blocker without RAAS blockade
E. Sodium restriction alone
Correct Answer: B. ACE inhibitor or ARB with target BP <130/80 mmHg
EXPERT RATIONALE: ACE inhibitors and ARBs provide renoprotection in diabetic
nephropathy beyond blood pressure lowering by reducing intraglomerular pressure and
proteinuria. Target BP per CMDT 2026 guidelines is <130/80 mmHg in diabetics with
CKD. They are first-line regardless of baseline BP.
7. A 70-year-old woman presents with acute onset confusion, fever of 39.2°C,
nuchal rigidity, and photophobia. CSF analysis shows glucose 30 mg/dL (serum
glucose 110), protein 180 mg/dL, and WBC 1200 cells/µL (90% neutrophils).
What is the most appropriate initial management?
