67-year-old Caucasian female who has history of Type 2 diabetes mellitus (DM) presents to your office for a cat bite to her right thumb. She was bitten by a neighborhood cat 3 days ago. Her thumb is red, inflamed, and painful. Yesterday the nurse practitioner saw the patient in the clinic; the bite area was […]

Ariel, a 25-year-old woman who works in the lab with you has severe rheumatoid arthritis and is receiving anti-TNF monoclonal antibody therapy to immunosuppress her autoimmune response. Unfortunately, this therapy causes generalized immunosuppression. Ariel was gardening on Saturday and cleaned up the very back part of her yard that contained rotting apples and leaves that […]

DM is an 8-year-old boy who presents today with his mother for a psychiatric evaluation. The Patient was referred by PCP as current meds do not manage his ADHD symptoms. Per the mother, the patient continues to have difficulty sitting still, struggles with homework, gets easily frustrated, yells and screams at home, and can be […]

The patient is a 41 year old Type 2 diabetic patient who has been treated with corticosteroids for severe inflammatory bowel disease (IBD) for the past few months. Recently he has had a “normal” fasting blood glucose levels, but progressively elevated pre-lunch and pre-dinner glucose levels. Which of the following would be the most appropriate […]

60 year old woman with T2DM follow-up visit. Regimen: NPH 14 units QAM and 10 units QPM, and lispro 8 units TID AC Pre-prandial: SMBG 3x/day Date Breakfast Lunch Dinner Mon 270 120 90 Tue 246 128 110 Wed 260 118 118 Thurs 268 100 98 Fri 290 132 120 Sat 242 124 88 Sun […]

52 year old female diagnosed with T2DM 6 years ago. At diagnosis: A1C = 10.1%, Wt = 180 lbs, Ht = 5’5″ BMI = 30 Current regimen: Max dose metformin & glipizide Recent labs: A1C: 8.8%; FBG: average of 210 mg/dL What basal insulin and dose should be initiated? 52 year old female diagnosed with […]

  0 year old male diagnosed with T2DM 8 years ago. At diagnosis: A1C = 13.3%, Wt = 310 lbs, Ht = 6’0″ BMI = 42 Current regimen: Max dose metformin & glipizide Recent labs: A1C: 11.5%; FBG: averages 260 mg/dL What basal insulin and dose should be initiated? 60 year old male diagnosed with […]

Timmy, an 8-year-old male, presents to his family doctor with a progressively worsening sore throat of 2 day’s duration. His other symptoms consist of headache, malaise, loss of appetite, abnormal taste, soreness in his neck, and difficulty swallowing. He is particularly distressed by his sore throat. Physical exam reveals a temperature of 101.2 F, tender […]

A 52-year-old female patient presents with non-specific abdominal discomfort, including bloating, feeling full quickly after eating small amounts, and urinary urgency. These symptoms have progressively worsened over the last few months. Considering ovarian cancer as a differential diagnosis, which of the following additional symptoms, if reported, would be most consistent with this diagnosis? Question 21Select […]

Leah Campo 69 has Alzheimer’s disease. She is originally from the Philippines and has been married to Danilo, her husband, for 51 years. He is her primary caregiver in the home. Mrs. Campo has periodic urinary incontinence, she wanders, and she frequently forgets how to perform personal activities and routine tasks in the kitchen. One […]