A 21-year-old woman presents with urinary frequency. Her BMI is 41. A urinalysis is positive for glucose. Her random blood sugar is 257 mg/dL, hemoglobin A1c is 8.5%, and C-peptide is 1.5 ng/mL. She is diagnosed with type 2 diabetes; diet and exercise are recommended.What is the drug of choice for managing her diabetes?

A 50-year-old man with a history of DM and CKD presents to your office for a follow-up   appointment for his hypertension. He reports some non-specific muscle weakness, so you decide to perform an ECG. The ECG demonstrates peaked T waves in several leads without any other abnormality. His labs reveal BUN 12, CO2 22, creatinine 1.0, Glucose 97, K 7.2, Cl 101, and Na 137. What medication is most likely to cause this ECG finding?

A 58-year-old man presents with a recent episode of rectal bleeding. A brief history reveals that his bowel patterns have been increasingly erratic over the past 6 weeks. He reports periods of 2-6 days without bowel movements followed by copious production of thin coils of stool. He has lost 10 lb over the last month. His family history is significant for the death of his cousin from colon cancer. Physical exam reveals the patient is pale and febrile (temperature 101°F); the rectal exam is heme-positive with scant stool, and his prostate is soft and moderately enlarged.What is the most appropriate evaluation method in the diagnosis of colorectal cancer?

A 56-year-old man presents with a 1-week history of palpitations and shortness of breath. He has a longstanding history of poorly controlled hypertension. Physical examination reveals an elevated blood pressure of 190/98 mm Hg, elevated jugular venous pressure, mild hepatomegaly, bilateral pedal edema, and rales at the lung bases. Echocardiogram reveals concentric left ventricular hypertrophy without significant valvular abnormalities. What drug is beneficial in the treatment of the patient’s condition by causing afterload and preload reduction?

A 35-year-old woman notices a change in the appearance of a mole on her neck. Physical examination reveals that the lesion is an irregular nodular superficial mass with a variegated appearance. Biopsy demonstrates a primary malignant tumor. What characteristic of the malignant skin lesion is most predictive of the patient’s long-term prognosis?

A 72-year-old woman presents with a 2-week history of fever, cough, and excessive diuresis. The woman has diabetes mellitus that is being treated with glimepiride (Amaryl). Her fluid and food intake have been poor during this time, as well. On physical examination, blood pressure is   98/58 mm Hg, pulse is 112/min, temperature is 100.6°F, and respirations are shallow and regular at 20/minute. On physical assessment, the patient is stuporous, skin and mucous membranes are dry, heart has a regular rate and rhythm without murmurs, and auscultation reveals rales in the left lung base. Her serum BG level is 602 and blood pH 7.35. She is diagnosed with pneumonia. Based on this information, what is this patient’s most likely concomitant condition?

A 44-year-old obese woman presents with increased nighttime urination. She has never had issues with having an increased urge to urinate nocturnally before, and it is extremely bothersome to her. She states that she has been waking up at least 3 times a night despite lifestyle modifications designed to help reduce this number. The patient admits to increased fatigue, worsening blurry vision, and two vaginal yeast infections in a span of 3 months. What is the most likely diagnosis?

A 20-year-old male presents to the primary care office for a routine wellness visit and is without complaints.  The patient states that he feels entirely well, denies recent acute illness, and has no significant PMH.  On physical examination, heart rate is noted to be irregular.  A baseline EKG is obtained.   Based on this rhythm strip (see image below), what is your initial diagnosis?  

A 64-year-old man with a history of a remote myocardial infarction and congestive heart failure presents for his 3-month follow-up. A recent echocardiogram reveals severe left ventricular   dysfunction.What intervention has been shown to reduce the risk of sudden cardiac death in similar patients?

Which procedure does the surgeon use to create an arteriovenous fistula aiding hemodialysis (HD) in the patient with renal failure?