Your patient with recurrent abdominal pain has an abdominal X-ray series completed. The results report, “skip lesions” & “string signs”. You interpret this as:  

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According to Greene, what is the descriptive trolley problem?

The most common differential diagnoses for chronic cough includes all of the following except: 

A nurse is providing teaching to the parent of a child who has a new prescription for liquid PO iron supplements.  Which of the following statements by the parent indicates an understanding of the teaching?

All smokers should be counseled on the benefits of smoking cessation because by the time symptoms develop, the patient’s FEV1 will have reduced by approximately 50%.  

Haidt (R11) discusses a conversation with a taxi driver in which the driver says “We will return to Jordan because I never want to hear my son say ‘f*** you’ to me.”  According to Haidt, the driver’s concern deals with which moral foundation?

A tall, thin 21-year-old male has sudden sharp pain in the chest and dyspnea. What differential diagnosis is most likely? 

A 64 year old woman presents with a 3-month history of upper abdominal pain. She describes the discomfort as an intermittent, centrally located “burning feeling” in the upper abdomen, most often occurs with meals and accompanied by mild nausea. Use of an over the counter antacid provides partial symptom relief. She also uses naproxen sodium on a regular basis for the control of osteoarthritis pain. Her clinical presentation is consistent with: 

A 48-year-old woman calls 911 and is brought to the emergency room complaining of a sudden onset of dyspnea. She reports she was standing in the kitchen making dinner, when she suddenly felt as if she could not get enough air, her heart started racing, she became lightheaded and felt as if she would faint. She denied chest pain or cough. Her medical history is significant for gallstones, for which she underwent a cholecystectomy 2 weeks ago. The procedure was complicated by a wound infection, requiring her to stay in the hospital for 8 days. She takes no medications regularly, only acetaminophen as needed for pain at her abdominal incision site. On examination, she is tachypneic with a respiratory rate of 28 breaths per minute, oxygen saturation is 84% on room air, heart rate 124, and blood pressure 118/89 mm Hg. She appears uncomfortable, diaphoretic, and frightened. Her oral mucosa is slightly cyanotic, her jugular venous pressure is elevated, and her chest is clear to auscultation. Her apical heart rhythm is tachycardic but regular rhythm with a loud S2 in the pulmonic area, no gallop or murmur. Her abdominal examination is benign. Incision site is normal without signs of infection. Her right leg is moderately swollen from mid-thigh to her feet, and her thigh and calf are mildly tender to palpation. Laboratory studies including cardiac enzymes are normal, her electrocardiogram (ECG) reveals sinus tachycardia, and her chest X-ray is interpreted as normal.  What is your next step?