A 27-year-old woman presents for her yearly gynecological examination. She has a history of bipolar disorder and has been euthymic for the last year on valproate. She recently got married and would like to conceive in the near future. Which of the following would you recommend to the patient based on your knowledge of bipolar […]

A 63-year-old man has been experiencing increasing confusion and agitation for the past 4 hours. His symptoms started with a headache earlier in the day, then he became very anxious and started pacing around the house. He has a history of depression and a recent back injury at work last week. His current medications are […]

A 30-year-old woman with a history of a body mass index of 22 kg/m2, regurgitation, and pyrosis is following up in the clinic after 4 weeks. She explains to the clinician that she has significantly reduced her alcohol intake and takes her daily omeprazole as directed with minimal relief. Which of the following is the […]

A 52-year-old man presents to the clinic for follow-up on his persistently elevated blood pressure. The patient recently had a computed tomographic angiography that showed renal artery stenosis on the left. His blood pressure in the office is 162/98 mm Hg. The patient is currently taking amlodipine 5 mg PO once daily. Which of the […]

A 56-year-old woman presents to the physician at the request of her daughter. The patient’s spouse passed away unexpectedly 14 months ago from a heart attack. She tells you that she has been having a very difficult time since her spouse’s death. She has not been sleeping well because she cannot get used to sleeping […]

A 69-year-old woman visits her primary care provider because of facial asymmetry that started yesterday. She felt fine and went to bed, hoping it would go away, but it is getting worse today. She has no difficulty speaking, weakness, or numbness in her arms or legs. Her chronic medical problems include type 2 diabetes mellitus, […]

A 55-year-old woman presents to the provider with repeated episodes of dizziness for the last 3 months, which are triggered by rising from a supine position and by lying down. The episodes are sudden and usually last for less than 30 seconds. During the episodes, she feels as if the world is suddenly spinning around […]

A 28-year-old woman was diagnosed with genital herpes 1 year ago. She has an outbreak most months that lasts 3 or 4 days. She is starting a new sexual relationship and wants to know how she can prevent giving her new partner herpes. Which of the following interventions will be most effective in preventing transmission […]

A 55-year-old woman presents to the provider with repeated episodes of dizziness for the last 3 months, which are triggered by rising from a supine position and by lying down. The episodes are sudden and usually last for less than 30 seconds. During the episodes, she feels as if the world is suddenly spinning around […]

An 81-year-old man with a history of hypertension, hyperlipidemia, and chronic lower extremity edema is following up at a clinic for an irregularly shaped, shallow wound on his right medial malleolus that has been present for 5 weeks. He tells the clinician that he has been using a combination of honey with calcium alginate and […]