32 year old female having excision of a mass in left breast. physician makes a curved incision along the inferior and medical aspect of the left ariola.a breast nodule, measuring 1 cm in diameter.was benign, firm, gray. disscrete. it was excised. no evidence of malignancy. bleeding controlled with electrocautery. skin edges were a continuos subcuticular […]

Joe is 13 years old and was diagnosed with mild, intermittent asthma 1 year ago. At his quarterly follow up visit, you discover he is using his Albuterol MDI at least 5 times a week (with good technique) for relief of symptoms. His mother reports that he also awakens at night frequently due to coughing […]

Henry P, age 72 years has been a smoker for 45 pack years. He was seen 2 weeks ago for increasing dyspnea with activity, chronic productive cough. Spirometry was completed and he returns today for follow up. Spirometry results show FEV 1 is 70% and FEV1/FVC is 68%. You recognize that this is consistent with […]

Letta, age 78 presents for hospital follow up. She has been maintained on an inhaled corticosteroid, a long-acting beta agonist, a long-acting muscarinic agent and montelukast (Leukotriene inhibitor) for her chronic obstructive pulmonary disease (COPD) for the past 1 1/2 years. On chart review, you see that this was her second occurrence of pneumonia in […]

Sadie W., 32 year old female, presents with symptoms of a runny nose, itchy eyes, and nasal congestion that occurs every spring. She is a school bus driver so tells you she wants something to relieve her symptoms but not make her drowsy. The nurse practitioner determines that Sadie has seasonal allergic rhinitis. The nurse […]

Eddie R, age 32 is a 12 pack year smoker and is interested in quitting smoking. He has a history of a seizure disorder and schizoaffective disorder with tendency toward hallucinations and disturbing dreams. Given your knowledge of treatment options for smoking cessation, the rest option for this patient would be: ) Abrupt discontinuation to […]

Mrs. Martinez called the First Care Family Practice Clinic to schedule an appointment for her 3-year-old daughter. Upon attempting to gather patient information, you notice that she is speaking primarily in Spanish and speaks very little English. As you attempt to gather information, you find that you are having great difficulty understanding what she is […]

Ella, age 64 presents to the clinic for blood pressure (BP) follow up. Her BP today is 138/88. You notice that she has consistently run in the high 130s systolic over high 80s diastolic for the past 1 year. She is a 30 pack year smoker and overweight. She was recently started on a statin […]

age 78 years is accompanied to the clinic by her daughter who indicates her mother has fallen twice in the past week and fainted while getting her hair done. Current medications include lisinopril 20mg daily (ACE-I) for many years, rosuvastatin 20mg daily (statin) and a daily multiple vitamin (supplement) for older adults. Her BP today […]

Dan B. is a 48 year-old African American male who presented for a health maintenance exam. His BMI is 28.2, but he has no other comorbidities (negative for diabetes and smoking). Routine fasting lipid screening reveals TC of 234mg/di (high). His HDL-C is 32 (low), LDL is 144 (high) and TG are 134 (normal). Blood […]