Tony, an advanced practice nurse, is conducting a telehealth virtual exam. Tony instructs the 65-year old male patient to sit in a chair and to perform the following maneuvers: Extend his left leg and pull his left toes toward his body. Next, tuck his chin down to touch his chest. If pain is elicited in the patient’s left buttock and leg, then this could indicate:
Read DetailsJoy, a 32-year-old hairdresser presents to the primary care clinic with complaints of pain and stiffness in her hands. Seven months ago, Joy began noticing stiffness in both hands in the morning that is now lasting “longer and longer.” Stiffness now lasts more than 1 hour every morning and includes hands, wrists and ankles. She also has increasing difficulty standing for long periods at work or at home due to foot and ankle pain. She has been taking ibuprofen 800mg 3 times daily and finds it helps her get through her day with less pain and stiffness. Physical examination of all of Joy’s joints demonstrate that many of the joints in the hands and feet are tender, warm and swollen bilaterally. Which of the following tests is most specific to make the likely differential diagnosis for Joy?
Read DetailsHugo, a 48-year-old male, is in the primary care office today with his wife of 22 years. The patient reports having a resting tremor in his right hand and some stiffness in the right arm for over a year now. He thought the tremors were related to nerves and would eventually resolve on its’ own. He also doesn’t like going to the doctor and his wife finally convinced him to make the appointment today. On inspection you notice a pill-rolling movement in his right hand at rest that resolves with active movement of the hand. On further inspection, relative slowness of fine rapid movements of the right hand are noted along with rigidity to right arm. Which of the following diagnostics will you order as a part of his differential diagnosis workup? (choose all which apply)
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