The 68-years-old patient has been suffering from hypertension for 10 years. A proteinuria (0.3 g/l), hematuria, and casts detected at the regular screening urine test. The urine relative density ranged 1008-1012 in the Zimnitsky’s test, serum creatinine – 348 μmol/l. What is your diagnostic assumption? * A.Nephroagiosclerosis, III stage essential hypertension B.Chronic glomerulonephritis C.Acute pyelonephritis […]

A 32-years-old woman is worried about a headache, aching pains in the heart apex. Within two weeks of observation the BP has been ranging from 135/85 mm Hg to 170/100 mmHg. The heart borders are not changed, the loud S II is over the 2-nd auscultation point. What is your diagnostic assumption? A.II stage essential […]

This week’s Aquifer discussed a 72-year-old male patient with Alzheimer’s dementia. He has a medical history of COPD, hypertension, and moderate dementia. He presented with symptoms of increased confusion, nighttime restlessness, visual hallucinations, rapid breathing, and urinary incontinence for four days. During the office visit, the healthcare provider conducted the Montreal Cognitive Assessment (MoCA). His […]

Leon is a 63-year-old male with alcohol dependence. He drinks daily to the point of intoxication. He has to drink a lot considering his tolerance to alcohol. Leon would like to quit drinking at home and attend outpatient treatment. Which among the following is the best option that you could suggest? Group of answer choices […]

The 58-years-old patient has been noting an increase BP up to 180/120 mm Hg during the last 5 years. Overweight, purple (bluish) stripes on the skin of the upper shoulder girdle and the anterior abdominal wall; moonlike face, hypertrichosis. What is your diagnostic assumption? * A.Primary hyperaldosteronism B.Obesity, secondary hypertension C.II stage essential hypertension D.III […]

Bill is a 30-year-old male, who stands 5 feet 11 inches tall and weighs 205 pounds. His Body Mass Index (BMI) is 28.6, which classifies him as overweight. He works as a personal banker and has not made time for any type of planned exercise. His dad was diagnosed with Type 2 diabetes at age […]

A 30-year-old healthy female is diagosed with community-acquired pneumonia and prescribed erythromycin, but reports to the clinic complaining of vomiting and nausea after one day of therapy. She has a headache and sore throat. Her temperature is 99.6 degrees Fahrenheit, blood pressure is 105/80 mm Hg; heart rate is 88 and respirations are 18/minute. Her […]

Mary is a 35-year-old woman that has been diagnosed with hypothyroidism. Her labs today show a TSH of 20, MCV 78, MCHD 26, Ferritin 9, TIBC 418. She has a history of iron deficiency anemia for 2 months. Current medications include Kelp tablets daily, ibuprofen 400 mg daily as needed, and ethinyl estradiol/norgestrel one tablet […]

A 35-year-old woman presents with polycystic ovarian syndrome (PCOS). She wants to start trying to conceive soon. She currently has regular menstrual cycles since discontinuing birth control pills and 15 pounds of weight loss over the past few months. Her current list of medications includes a multivitamin with folic acid, albuterol (Ventolin), clindamycin topical lotion, […]

J.P. is a 37-year-old office manager who presents to her nurse practitioner with a complaint of arthritis in her wrists and ankles. She has gained 20 pounds in the past 6 months, despite eating a balanced diet. Her exercise regimen has suffered due to muscle cramps and headaches. On examination, the nurse practitioner palpates pitting […]