A 29-year-old woman who has struggled with maintaining a healthy weight for most of her life has decided to tackle her New Year’s resolution. On several different occasions, she has attempted to lose weight; however, she has never been successful. Every year, eager to begin her weight loss journey, she reads self-help books, joins exercise […]

Jack is a 6 week old infant presenting with his mother with continued concerns for spitting up after feedings. He has been in the office every 3-4 days for the spitting up. Mom has changed his formula four times since his birth without any changes in the spitting up. You had prescribed a trial of […]

Your 17 year old patient presents following a syncopal episode. His pulse and blood pressure reflect orthostasis with a change in pulse by 40 points from lying to standing. Based on his weight chart, he is down 15 pounds from his last visit 2 months ago. He is complaining of a change in the color […]

Ben is a 15-year-old seen in the clinic because of acne. You note that his face and neck are covered with comedones and inflamed pustules. He states that he has had a problem with acne for two years but has taken care of it at home by scrubbing his face 4-5 times per day and […]

Mrs. Villarreal (79) drives her husband, Francisco (82), to the hospital after demonstrating an inability to speak, difficulty breathing and grabbing his chest. Mr. Villarreal dies at the hospital of a massive heart attack. Mrs. Villarreal is frantic, begins wailing, and throws herself to the floor asking God, “why?” The social worker is called to […]

Mr. Richard Pilgrim is a personal trainer who was referred to your dental office by one of his clients. New to your practice, his chief complaint is “brown spots that show when I smile.” • In examining Mr. Pilgrim’s teeth, you note that the brown spots are calculus deposits that are stained (superficial, extrinsic stain). […]

Mrs. Kelly, a resident in a long-term facility, enjoys reading and doing crossword puzzles. One day as Morgan, a nursing assistant, is helping her get to the sunroom for her book club, he notices that she is agitated. When he asks if anything is bothering her, she tells him that she lost her glasses and […]

A client arrives to the clinic seeking mental health services. Belinda is 32 years old and lost her mother to complications of diabetes 2 years ago. Since the mother’s death, Belinda has been unable to return to work. She reported sleep and appetite disturbance, decreased energy, no interest in any leisure activity, socially isolated and […]

Mrs. Jenkins is a resident in a long-term care facility where Devon works as a nursing assistant. She is experiencing discomfort from hip surgery and is frustrated by her inability to move around. The pain medications Mrs. Jenkins is taking make her feel anxious, and every sound in the hallway magnifies her anxiety. When Devon […]

Lucille, a 76 year-old resident at a long-term care facility, tells Margaret, a nursing assistant, that she woke up this morning feeling like she had some kind of sore on the back of her upper thigh. Margaret takes a look at her leg and sees a large, hot, red lump that is later diagnosed as […]