A 25-year-old woman is pregnant. During her first prenatal visit, a right ventricular (RV) heave is felt and there is a blowing, holosystolic murmur that is heard best at the lower left sternal border. What is the most appropriate next step for evaluation of the murmur? Obtain an echocardiogram. Obtain an echocardiogram at her next […]

A 40-year-old restaurant manager is being seen by a cardiologist for progressive shortness of breath and lower extremity edema. On physical examination, blood pressure is 120/80 mmHg, jugular venous distension is 10 cm above the sternal angle with prominent a waves, the heart rhythm is regular, a right ventricular heave is present, and a loud […]

A 62-year-old accountant recently suffered an inferior myocardial infarction for which a stent was placed to his right coronary artery. A week later he is admitted to the hospital with severe fatigue and shortness of breath. On examination, the heart rate is regular at 30 beats per minute. What is the most likely heart rhythm? […]

Mrs. Smith, a 65-year-old female, presents to the clinic complaining of fatigue, weakness, and shortness of breath on exertion for the past few weeks. She reports no significant changes in her diet or exercise routine but mentions a history of heavy menstrual periods. On examination, Mrs. Smith appears pale, with conjunctival pallor noted. Her heart […]

A 45-year-old immigrant from sub-Saharan Africa is admitted to the hospital with several months of shortness of breath, abdominal distension, and pitting lower extremity edema. On physical examination, the jugular venous pressure is estimated at 15 cm above the angle of the sternum and the pressure increases during respiration. A blowing, holosystolic murmur is heard […]

Johnny Tiko, an energetic 7-year-old, arrives at the clinic with his mother. Johnny’s mother states that his teachers report he is easily distracted by extraneous stimuli, has difficulty sustaining attention in tasks or play activities, leaves his seat when remaining seated is expected, and has difficulty waiting his turn. Johnny’s mother expresses concern about his […]

A 7-year-old girl is brought to the pediatrician’s office because her parents have noticed that she “cannot keep up with her friends anymore.” On physical examination, a harsh, medium-pitched murmur depicted in the figure below is heard best at the left second interspace. S2 is widely split. What is the most likely cause of this […]

A 22-year-old woman hyperventilates every time she drives over a bridge and slows to a dangerously low speed. She tries to rationalize her reaction by explaining that she is just being cautious and protecting herself from traffic, but the hyperventilating and slow pace is dangerous. She realizes that this is irrational but is unable to […]

A 35-year-old woman presents at clinic with fever, productive cough, diarrhea, headache, anorexia, sore throat and dysphagia. She notes a ten-pound weight loss since her last visit 3 months ago. She has had unprotected sexual intercourse with more than one partner over the course of the past year. On physical exam crackles were heard at […]

Every individual has a story to tell, shaped by their experiences, passions, and the paths they choose to follow. In geriatric social work, these stories become intertwined with a commitment to care for and support our elderly population, particularly those who have served our country with courage and dedication. In the context of aging services, […]