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.
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MKSAP 18 Q & A
A 43-year-old man is evaluated for knee, hip, shoulder, and arm stiffness, worsening over the past year. He also has pain in the arms, legs, neck, and torso, both on and between the joints. He states that his discomfort is continuous. He also reports chronic fatigue, lack of sleep, a band-like headache, and difficulty concentrating. He also has intermittent constipation and diarrhea. He takes acetaminophen and ibuprofen as needed for pain without much benefit.
On physical examination, the patient appears tired and anxious, with no acute distress. Vital signs are normal. He has minimal tenderness on palpation of multiple muscle groups. Full range of motion of all joints without crepitus is noted. There is no joint swelling or rash.
Laboratory studies, including complete blood count, erythrocyte sedimentation rate, serum creatine kinase, and thyroid-stimulating hormone, are within normal limits.
Which of the following is the most likely diagnosis?
A: Fibromyalgia
B: Hypothyroidism
C: Osteoarthritis
D: Rheumatoid arthritis