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A 58-year-old man presents with epigastric pain and nausea….

A 58-year-old man presents with epigastric pain and nausea. Upper endoscopy reveals erythematous, friable gastric mucosa without ulceration. Biopsy is negative for H. pylori. He reports daily NSAID use for chronic back pain and drinks alcohol on weekends. Which management plan is most appropriate?

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A 58-year-old woman with a history of abdominal surgery pres…

A 58-year-old woman with a history of abdominal surgery presents with intermittent abdominal pain and bloating over several weeks. She continues to pass flatus and has occasional bowel movements. CT imaging shows dilated small bowel loops with air present in the distal colon. Which interpretation is most accurate?

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A 71-year-old man presents with progressive abdominal disten…

A 71-year-old man presents with progressive abdominal distention, constipation for 4 days, and mild crampy lower abdominal pain. He reports minimal nausea and has not vomited. He also notes unintentional weight loss over the past 3 months. Which diagnosis is most consistent with this presentation?

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A 45-year-old woman with type 2 diabetes presents with nause…

A 45-year-old woman with type 2 diabetes presents with nausea, vomiting, and abdominal pain. She recently started canagliflozin and has been following a low-carbohydrate diet. Laboratory studies reveal glucose 125 mg/dL, arterial pH 7.19, serum bicarbonate 12 mEq/L, anion gap 26, and elevated serum ketones. Which management strategy is most appropriate?

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A 32-year-old man presents with a long history of intermitte…

A 32-year-old man presents with a long history of intermittent solid-food dysphagia and several episodes of food impaction requiring emergency evaluation. He has a history of asthma and allergic rhinitis. Upper endoscopy reveals esophageal rings and linear furrows. Which diagnosis best explains this patient’s presentation?

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When performing a transcranial Doppler examination, which ty…

When performing a transcranial Doppler examination, which type of velocities are primarily used for interpretation?

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The vertebral arteries primarily supply blood to which of th…

The vertebral arteries primarily supply blood to which of the following regions?

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¿Pero o sino? Cristina has trouble giving a simple answer to…

¿Pero o sino? Cristina has trouble giving a simple answer to any question. Complete her statements about her preferences by writing either pero or sino.   1) Me encanta ir al cine, [a1] a veces también es lindo quedarme en casa. 2) Hoy, la verdad, no quiero hacer yoga [a2]  leer una buena novela. 3) No me gusta nadar en el mar [a3] en una piscina. 4) Esta noche mi novio quiere salir a comer, [a4] yo quiero ir a una discoteca. 5) A los dos nos encanta escuchar música, [a5] curiosamente, casi nunca vamos a conciertos. 6) La última vez que decidimos ir a un concierto, nos equivocamos (we made a mistake); ¡el espectáculo no fue a las diez de la mañana, [a6] a las diez de la noche!

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Subjuntivo o indicativo. Complete these sentences with eithe…

Subjuntivo o indicativo. Complete these sentences with either the present indicative or present subjunctive of the verb in parentheses.   1. Miguel no niega que [a1] (necesitar) comer mejor.   2. Ellos niegan que su hijo [a2] (ir) de vacaciones a Hawai.   3. Cristina no piensa que [a3] (haber) una solución al problema.   4. Mi tío niega que él y su esposa [a4] (ser) ricos.   5. Creemos que nuestra sobrina [a5] (tener) gripe.

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Objetos directos y indirectos. Replace the objects in each s…

Objetos directos y indirectos. Replace the objects in each sentence with direct and indirect object pronouns.  Modelo: Les doy las flores a mis padres. — Se las doy. 

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