A 58-year-old man presents with a history of increased fatigue and general malaise. He also reports a gnawing epigastric abdominal pain that radiates to his back that he has experienced intermittently for years. His epigastric pain has increased in frequency and intensity over the last three months. Over the same period, he has experienced cluster […]

A 17-year-old high school student with a history of asthma is evaluated for recurrent epigastric discomfort. On exam, a 1 cm midline protrusion is noted in the epigastric region between the xiphoid process and the umbilicus. His skin is otherwise normal. Auscultation reveals normal bowel sounds. Percussion is also normal and nontender. Palpation of the […]

A previously healthy 21-year-old mother of two young children presents to the emergency department with fever, nausea, and vomiting. She denies any diarrhea, abdominal or pelvic pain. She does note a vague thoracic back pain that she had attributed to lifting her 22-month-old daughter. The physician performs an abdominal examination and assesses her kidneys for […]

A 26-year-old man presents to an outpatient clinic with a three-week history of loose bowel movements occurring 6-8 times daily. He denies any abdominal pain between bowel movements, but does get crampy lower quadrant pain just prior to bowel movements. His paternal uncle has ulcerative colitis. Which of the following additional findings on history would […]

Cindy is a 29-year-old female who presents to the ER complaining of feeling weak, tired with joint and muscle pain. She reports feeling “cold all the time” and a 30 lb. weight gain in the last 8 months. Patients states that she has been experiencing recurrent headaches, mild constipation and a lack of a menstrual […]

A 75-year-old woman was admitted to the nursing facility for occupational therapy following cardiac bypass surgery. She continues to have significant acute post-thoracotomy pain. Select the answer with the correct codes, in the correct order. 1) Aftercare, following surgery, circulatory system (Z48.812), Status, aortocoronary bypass (Z95.1), Pain, acute, post-thoracotomy (G89.12) 2) Aftercare, following surgery, circulatory […]

And 9 90 year old patient who was admitted and diagnosed with multiple organ failure had an advanced directive stating to withhold all treatment the daughter was strongly against honoring the advanced directive of her father standing as a patient caregiver she expressed her intention to continue the dialysis session with her father how should […]

A 40-year-old man who does not have housing presents for a 3-week follow-up with a nurse practitioner. The patient recently emigrated from Somalia and presented with pellagra at his previous visit. How would the nurse practitioner know whether the treatment has been effective? Decrease in lower extremity edema Decrease in proptosis Decrease in scaly rash […]

A 34-year-old woman presents to the clinic for a follow-up evaluation. She was recently diagnosed with porphyria cutanea tarda. Which of the following is most likely to have been appreciated on initial history taking and physical examination? Abdominal pain and nausea Altered affect Hyperkeratosis Photosensitivity

A 60 yo female PTC with recent diagnosis of type 2 diabetes. She was prescribed 500mg BID of Metformin and reports that she was told to “eat better” by her PCP but she admits that she does not know what that means. She is looking for your advice regarding nutrition and lifestyle changes. She heard […]