Harrison's Principles of Internal Medicine, 21e Joseph Loscalzo, Anthony Fauci, Dennis Kasper, Stephen Hauser, Dan Longo, J. Larry Jameson 2025 Update

Part 1: The Profession of Medicine Chapter 1: The Practice of Medicine 1. What is the primary focus of patient-centered care in contemporary medicine? A. The physician’s expertise B. The patient’s preferences and values C. Advanced diagnostic technologies D. Insurance coverage Answer: B. The patient’s preferences and values Rationale: Patient-centered care emphasizes understanding and respecting the patient’s individual preferences, values, and needs, and involves them in all aspects of their treatment plan. 2. Which of the following principles is essential in practicing evidence-based medicine? A. Reliance on clinical experience alone B. Prioritizing patient wishes over scientific evidence C. Using the best available research evidence D. Avoiding consideration of healthcare costs Answer: C. Using the best available research evidence Rationale: Evidence-based medicine integrates clinical expertise with the best available research evidence and patient values to guide clinical decision-making. 3. A 60-year-old woman presents with chronic back pain. After reviewing her imaging results, the clinician suggests a patientcentered care approach. What does patient-centered care prioritize? A. Clinician’s diagnosis B. Medical costs C. Patient’s preferences and involvement in decision-making D. Strict adherence to clinical guidelines Answer: C. Patient’s preferences and involvement in decision-making Rationale: Patient-centered care emphasizes the importance of understanding the patient’s individual preferences and involving them in the decision-making process. 4. Which of the following is NOT a core principle of patient-centered care? A. Respect for the patient’s values B. Making decisions without consulting the patient C. Providing clear communication D. Emotional support Answer: B. Making decisions without consulting the patient Rationale: A core principle of patient-centered care is to involve the patient in decision-making and respect their values and preferences. 5. A physician is considering two different treatment plans for a patient with heart failure. Both treatments have similar efficacy, but one is more expensive. How should the physician decide? A. Choose the most expensive treatment B. Choose based on the physician’s preference C. Avoid discussing the costs with the patient D. Include the patient in the decision and discuss the costs Answer: D. Include the patient in the decision and discuss the costs Rationale: Patient-centered care involves discussing the treatment options, including the financial aspects, and allowing the patient to participate in the decision. 6. Which of the following best defines evidence-based medicine? A. Treating all patients the same way B. Using the best available evidence, clinical expertise, and patient preferences C. Relying on clinical trials exclusively D. Ignoring patient preferences Answer: B. Using the best available evidence, clinical expertise, and patient preferences Rationale: Evidence-based medicine combines clinical expertise, the best available research, and consideration of patient values. 7. A 40-year-old patient is hesitant to take the recommended treatment for diabetes due to fear of side effects. What is the best approach to promote shared decision-making? A. Ignore the patient's concerns B. Provide the patient with clear information about risks and benefits C. Prescribe the medication without further discussion D. Reassure the patient without any explanation Answer: B. Provide the patient with clear information about risks and benefits Rationale: Shared decision-making involves informing the patient about risks, benefits, and alternatives, ensuring they have the information to make an informed choice. 8. Which of the following is an advantage of using clinical decision support systems (CDSS) in medicine? A. Reduces diagnostic errors B. Replaces clinician judgment C. Removes the need for patient history D. Avoids communication with the patient Answer: A. Reduces diagnostic errors Rationale: CDSS can improve accuracy in diagnosis and treatment recommendations by providing evidence-based clinical guidelines. 9. A physician suspects a patient has pneumonia but is unsure of the best antibiotic regimen. How can evidence-based medicine assist in this scenario? A. Ignoring the patient’s medical history B. Consulting clinical guidelines based on the latest research C. Making a decision based only on personal experience D. Relying solely on patient demand Answer: B. Consulting clinical guidelines based on the latest research Rationale: Evidence-based medicine encourages the use of the best available research to guide treatment decisions.