A 51-year-old comes to you with acute pain and swelling of the knee. Joint fluid analysis confirms the diagnosis of acute gout. She has a past medical history of atrial fibrillation, hypothyroidism, hypertension, and prior treatment for H. pylori infection. Her current medications include losartan, warfarin, levothyroxine, and omeprazole. She is allergic to penicillin medications. […]

Mr. B is a 50-year-old male who comes into the office complaining of sharp chest pain in his mid-sternum of 24 hour duration. The pain has been steady and radiates to his left arm, worsened by swallowing, deep breathing and relieved by sitting up or leaning forward. He notes occasional tightness in his chest but […]

A 45-year-old Hmong woman, Ms. T., moved to Detroit, Michigan, with her husband and daughter. Her husband is HIV-positive. Her husband was abusive, and their marriage eventually ended. A few years ago, the client was diagnosed with HIV and hepatitis C. Since her diagnosis, Ms. T. has struggled with adhering to antiretroviral therapy. Though often […]

An 18-year-old-male present to an urgent care facility for evaluation of diarrhea and abdominal pain. The patient noticed mild tenderness and abdominal discomfort and three loose bowel movements per day a week ago. Two days ago, he started having intermittent, crampy lower abdominal pain. He denied drinking well water, fever, blood in the stool, or […]

A 55-year-old patient with no health problems presents to the office with left shoulder pain. She is a tennis player, left-handed, and notices pain serving the ball. When you suggest that it might be her rotator cuff your preceptor asks, “what muscles make up the rotator cuff?” A. Supraspinatus, infraspinatus, teres major, subscapularis B. Supraspinatus, […]

A 36-year-old patient presents to the clinic with a four-month symptoms that lead to a diagnosis of major depressive disorder. She reports no significant past medical history and has no known drug allergies. Her family history is non-contributory. This is her first time seeking treatment for these symptoms. Considering her clinical presentation and history, what […]

A 41-year-old patient presents to the clinic with left shoulder pain after a fall where he caught himself with his left arm. To assess the injury, the patient was asked to abduct both arms to 90 degrees and then to bring them anteriorly with a 30 degrees forward flexion. Then the patient was asked to […]

The patient is an 11-year-old Native American girl who resides with her biological father, his girlfriend, two younger sisters, and a newborn, half-brother in a small apartment located on a reservation in Southeast South Dakota. The patient is in 5th grade and attends the public school. The patient’s presenting problem is her behavior, which is […]

A 45-year-old patient presents to the primary care clinic with a sudden onset of unilateral facial weakness. The patient describes experiencing drooling, loss of taste on the affected side, and ear pain. There are no reports of fever, neck stiffness, or other systemic symptoms. Physical examination reveals flaccid paralysis of the facial muscles on one […]

A 25-year-old patient reports having ‘sinus headaches’ about 4 to 5 times a year for the last 5 years. The headache lasts for about 24 hrs. and usually occurs around her menstrual cycle. A healthcare provider has not confirmed the diagnosis of sinus headache; instead, the patient has ‘self-diagnosed’ themself. Pain is located around the […]