A 26-year-old male presents to the urology clinic for evaluation of a painless mass in his left testicle. He said he noticed it the other day when he was performing testicular self-examination. You palpate his scrotum and note a ‘bag of worms’ consistency in his left hemiscrotum. Which of the following conditions is the most likely diagnosis for this patient?

You are asked to evaluate a 32-year-old woman who presents complaining of “worsening stress.”  On further questioning, the patient admits that she is developing a severe fear of public places and open areas, and this has started to affect her ability to function.  She left her previous job due to this escalating discomfort, and now rarely leaves her home.  She realizes that her fears are seriously affecting her ability to function, and, despite considerable anxiety, has come to the office today to get help.  Based on this information, which of the following conditions is the most likely diagnosis for this patient?

A 36-year-old male patient presents for initial psychiatric evaluation and is accompanied by his wife.  She explains that her husband’s behavior is negatively affecting their personal relationship and his interactions with co-workers at the office.  She describes her husband’s overwhelming need for order, strong sense of “how things should be done,” perfectionism that interferes with completing tasks, and rigidity about following rules.  Which of the following conditions is the most likely diagnosis for this patient? 

A 36-year-old female presents with a history of gradual onset of nervousness and fatigue. She has lost 15 pounds in the past year despite an increase in appetite.  She reports that she is not sleeping well, because she feels anxious all of the time. Her menses have become scant with frequent intermenstrual spotting, and she feels that she constantly prefers a cooler environment than those around her. On physical examination, she has a heart rate of 100/min with normal blood pressure, and a fine tremor of the fingers is noted. The skin is warm, moist, and has a smooth texture. The thyroid is diffusely enlarged to palpation. A lid-lag sign is easily demonstrable. A common complication of this disease is:

A pregnant woman at 30 weeks gestation reported a flu-like illness to her provider. Suspecting Cytomegalovirus infection, laboratory testing was completed. The results showed positive CMV IgM antibodies with high avidity CMV IgG antibodies. Which of the following statements is true concerning this fetus after delivery?

During your Psychiatry rotation, you are asked to evaluate a 34-year-old male patient with signs and symptoms suggestive of Bipolar I disorder.  The patient is started on lithium and your preceptor asks you to review with the patient the possible common side effects associated with this medication.  Which of the following potential side effects should be included in your discussion with the patient? 

Which of the following statements about systemic sclerosis (scleroderma) is true?

A 26-year-old full-term pregnant woman presents with sudden onset of painless vaginal bleeding. She has no other relevant medical history. Her obstetric score is G2, P1, A0, and L1. Her first born is a 2-year-old healthy male child. On pelvic examination, there is active bleeding though the bleeding is moderate, and a 4.5 cm dilated cervix. She is found to have marginal placenta previa. Her pulse is 90/min, BP 100/60 mmHg and RR 20/min. Based on this information, which of the following interventions is the most appropriate management for this patient?

A 68-year-old male patient with PMH significant for HTN, stroke, vascular dementia, and atrial fibrillation, presents with a two-month history of generalized weakness and dizziness.  His symptoms began gradually, and have been progressing over the past few weeks, now affecting his ability to perform activities of daily living.  The patient reports an estimated unintentional weight loss of 20 pounds over the past two months, and his appetite has diminished.  The patient denies any fever, night sweats, headache, cough, hemoptysis, or dyspnea.  He denies abdominal pain, change in bowel habits, nausea, vomiting, or urinary symptoms.  Six weeks prior, the patient was initially evaluated in the ER and received IV fluids and electrolyte supplements for dehydration.  Physical examination reveals patchy hyperpigmentation of the elbows, knees, neck, and palmar creases.    Based on this information, which of the following conditions is the most likely diagnosis for this patient?    

A mother brings her 8-year-old daughter to the pediatrician’s office. She states that over the past few weeks the child’s teacher has noticed that the child occasionally stares off into the distance or pauses in the middle of a sentence. Yesterday, the teacher noticed facial twitching during one of these staring episodes, but it only lasted for a few seconds. The child doesn’t seem to have any memory of these episodes, and appears completely normal immediately following each occurrence.  The mother states that her pregnancy with the child was without complications, and you note that the child has achieved all developmental milestones uneventfully. The child is not currently on any medications. The mother has noticed similar episodes at home.  Based on this information, which of the following conditions is the most likely diagnosis for this child?