In what patient population seen frequently in the FNP’s office for a wellness visit is an elevated Alk Phos a normal finding?

Use the following case for the next 2 questions: Bill, a 33 year old male patient presents to your office with severe abdominal pain, nausea and vomiting. Sam has been your patient for the past 3 years. He tells you he has not been able to keep fluids down for the past 24 hours. Your physical assessment reveals tenderness in the epigastric region, LUQ and RUQ.  CBC – wnl,except WBC 13.8Na 138K 4.0Ca 9.6Cl 102CO2 21Glu 112BUN 17Cr .9Total protein 7.5Albumin 4.6Total bili 1.4AST 433ALT 343Alk Phos 273   Differential Diagnosis for Bill include:

Margaret presents to clinic today with a 4cm x 5cm edematous area on her right thigh with surrounding tissue erythema, warmth and an intact tender, soft center with purulent appearance.  She denies any history of prior abscesses or MRSA infections.  The most appropriate treatment plan for Margaret today is:             

During a yearly physical you find the following 1 cm lesion on David’s back.  You would:  

Identify the lesion.  14 year old male patient represents with lesions along the lower abdomen.  He reports “some of them have white stuff that will come out”.

You believe a lesion to be a melanoma.  The best technique for biopsy is a shave biopsy.

A 76 year old obese patient has fatigue, thirst, and frequent urination. She was asked to measure AM fasting glucose values for 1 week. The values range from 142-175 mg/dL. This patient: 

The American Diabetes Association defines diabetes as a HgbA1C of:

Normal range for TSH is .3 – 4.0 mlU/L

Which of the following is a normal Free T4 range?