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
A 58-year-old woman is evaluated in the emergency department for sharp, nonradiating pain in the left lower quadrant that has persisted for 2 days. She reports no fever, diarrhea, or blood in stools and has not traveled recently. Her last colonoscopy, performed 1 year earlier, showed pandiverticulosis.
On physical examination, her temperature is 37.2 °C (99.0 °F), blood pressure is 130/85 mm Hg, pulse rate is 88/min, and respiratory rate is 18/min; BMI is 26. Abdominal examination is positive for left-lower-quadrant tenderness on palpation with no rebound or guarding.
Results of laboratory studies show an elevated leukocyte count; other findings are normal.
Abdominal CT shows focal diverticulitis in the sigmoid colon, without abscess.
Which of the following is the most appropriate next step in management?
A: Colonoscopy
B: Intravenous antibiotics
C: Oral antibiotics
D: Surgery