Clickand select “Upload/Record Media.” Then select “Record.”…
Clickand select “Upload/Record Media.” Then select “Record.” This should bring up your webcam (if permissions are enabled). Click the “Mic” button and start your recording. Please read slowly and clearly the following Hebrew sentence: בְּרֵאשִׁית בָּרָא אֱלֹהִים אֵת הַשָּׁמַיִם וְאֵת הָאָֽרֶץ׃
Read DetailsA 52-year-old patient visits the clinic with a chronic cough…
A 52-year-old patient visits the clinic with a chronic cough, shortness of breath, and weight loss for 3 months. There are intermittent fevers and night sweats. A painful ulcerated lesion on the right leg has been growing. There is no recent travel outside of Michigan. On exam, there is an ulcerated erythematous lesion on the right shin, and crackles are heard in the left lower lung field. What additional finding will most strongly support the most likely fungal infection?
Read DetailsA 61-year-old female presents to her primary care physician…
A 61-year-old female presents to her primary care physician complaining of fatigue and feeling sad. She reports that ever since her husband passed away 3 months ago, she has noticed a decrease in her energy level and reports frequently awaking at 2 in the morning and cannot fall back asleep. She sometimes wakes up and hears her husband’s voice, constantly thinks about how much she misses him, and has recently thought about ways to kill herself including driving through a red light. She used to be an active member of her neighborhood’s bridge club but has stopped playing. She has lost 15 pounds and rarely feels hungry. Which of the following is the most likely diagnosis in this patient?
Read DetailsA 6-year-old boy is brought to the pediatrician complaining…
A 6-year-old boy is brought to the pediatrician complaining of itchy eyes. The mother states that she has noted that his eyes have been tearing and that both of his eyes have been red for the past 4 days. The patient denies any pain but has had a runny nose for the past week. The mother states that he has not had any sick contacts, and he has been home from school for summer vacation. She notices that his symptoms seem to improve in the evening after he showers. His temperature is 97.0°F (36.1°C), blood pressure is 100/66 mmHg, pulse is 90/min, respirations are 22/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding shown (see image). Which of the following is the most likely diagnosis?
Read DetailsYou are asked to evaluate a 62-year-old male patient who pre…
You are asked to evaluate a 62-year-old male patient who presents for a yearly physical, and is without new complaints. PMH is significant only for mild HTN, controlled with HCTZ. On examination, you note palpable lymphadenopathy in the cervical and axillary regions bilaterally. The patient denies recent acute illness, fever, night sweats, weight loss, fatigue, or other associated symptoms. The CBC results for this patient are as follows: WBC: 60,000, Hgb: 13.5, HCT 41% , Plt 168,000 Differential: 20% segs, 2% bands, 68% lymphs, 5% monos, 3% eos, 2% basos. Peripheral Blood Smear: Increased number of mature appearing lymphocytes; smudge cells noted; RBCs appear essentially unremarkable. Based on this information, which of the following conditions is the most likely diagnosis for this patient?
Read DetailsA 12-year-old boy is brought in by his parents as they are c…
A 12-year-old boy is brought in by his parents as they are concerned about his behavior. He is constantly arguing with his parents and blatantly defying their every request. In school, he is known for being intentionally tardy and for defying his teachers. Upon further questioning of the patient you learn about some of his recent behaviors such as beginning smoking to bother his parents. You also notice that he is disrespectful towards you. You then learn that he has also gotten into weekly fights with his peers at school with no apparent cause. In addition, last week he was seen hitting one of the local neighborhood cats with a baseball bat trying to kill it. The patient lives at home with his two parents in a pre-World War II house that was recently renovated. Physical exam is unremarkable. Laboratory values are as follows: Na: 140 mmol/LK: 4.5 mmol/LCl: 100 mmol/LGlucose: 80 mg/dLCa: 10 mmol/LMg: 3 mEq/LCr: 0.8 mg/dLBUN: 10 mg/dLSerum lead: < .01 µg/dLHb: 15 g/dLHct: 45%MCV: 95Urine toxicology: negative As the patient leaves the office you notice him taking all of the candy from the office candy bowl. The patient seems unconcerned about his behavior overall. Which of the following statements is most likely to be true in this patient?
Read DetailsA 63-year-old man undergoes uncomplicated laparascopic chole…
A 63-year-old man undergoes uncomplicated laparascopic cholecystectomy for acute cholecystitis and is admitted to the surgical ward for postoperative management. On postoperative day 1, routine laboratory studies reveal an increase in serum creatinine to 1.46 mg/dL from 0.98 mg/dL before the operation; BUN is 37 mg/dL, increased from 18 mg/dL on prior measurement; K is 4.8 mEq/L and CO2 is 19 mEq/L. The patient has an indwelling urinary catheter in place, draining minimal urine over the last few hours. After ruling out urinary catheter obstruction, which of the following is the most appropriate next step in management?
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