Bud Lancaster is an 82-year-old who presents with complaints…
Bud Lancaster is an 82-year-old who presents with complaints of problems concentrating and just not feeling well. He has had a recent upper respiratory infection that he thought was improving, but has lingered on for a few weeks now. His wife, who accompanies him today, is concerned that for the last few days, Bud has been more forgetful, short of breath, and just doesn’t seem to be himself. His appetite is diminished and he is sleeping very restlessly the last few nights as well. He is routinely on a low dose ACE inhibitor for hypertension (well controlled) and has NKDA. PMH: hypertension. VS: Temp 98.9, Pulse 96, Resp 24, BP 110/68, pulse ox 92%. Exam is unremarkable except for some post nasal drip. What is the best plan of care for Mr. Lancaster?
Read DetailsMelissa is a 67-year-old female patient with past medical h…
Melissa is a 67-year-old female patient with past medical history of emphysema, lymphoma, arthritis, cirrhosis, gout, and coronary artery disease who presents today with abrupt onset of fever (101.2 degrees), cough, body aches, and overall fatigue that began yesterday afternoon. Other vitals: BP 124/76, HR 76, RR 18, O2 sat 97%. Melissa is diagnosed with influenza. What is your best plan of care for this patient?
Read DetailsA 22-year-old presents with fever for 24 hours, temp max 101…
A 22-year-old presents with fever for 24 hours, temp max 101.8 Fahrenheit. She has recently returned from vacation in France. Patient is current with both COVID and influenza vaccinations. Medical history is significant for mild persistent asthma. Allergies: Pollen. VS: T 101.0 Fahrenheit, Pulse 82, Resp 16, BP 110/70. Other than her fever and that she does not appear to feel well, her exam is normal. What is the best diagnostic approach for this patient?
Read DetailsIvan, a 69-year-old, presents with three days of feeling tir…
Ivan, a 69-year-old, presents with three days of feeling tired and productive cough of yellow-tinged phlegm. He reports he had a URI a week ago that has resolved. PMH: smoker 2 ppd x 48 years, COPD, Type 2 DM well-controlled with metformin, and has a permanent pacemaker. His exam reveals skin pale, crackles in LLL, positive tactile fremitus and egophony in LLL, normal S1S2, abdomen non-tender. You discuss with Ivan that you would like for him to get a CXR but he refuses because he says he does not have the money to pay for that. Your next best plan would be:
Read DetailsDon is a 74-year-old male, with past medical history of recu…
Don is a 74-year-old male, with past medical history of recurring bronchitis, chronic obstructive pulmonary disease, previously smoked 1 ppd X 60 years, type 2 diabetes, hypertension, and hyperlipidemia who presents today in clinic with symptoms of a common cold. You know it’s a cold, your patient Don knows it is a cold, but he tells you he is going up north in less than 48 hours to golf with a bunch of his buddies and he is asking for an antibiotic, because he knows it will make him feel better for his big golf trip. Select the best response.
Read DetailsFrank is an 81-year male patient of yours that lives in an a…
Frank is an 81-year male patient of yours that lives in an assisted living facility. You diagnosed Frank with influenza 4 days ago. You call the facility to see how Frank is doing. Which set of symptoms would concern you that Frank needs further evaluation?
Read DetailsHaley is a 31-year-old who presents with complaints of a cou…
Haley is a 31-year-old who presents with complaints of a cough for the last three days. Cough is productive of some clear, occasionally yellow tinged mucous. She denies fever, chills, nausea, vomiting or diarrhea. She has some nasal congestion, runny nose with clear mucous. No fever or chills. PMH: No chronic health conditions, No surgeries, no routine medications. VS show Temp 97.8, Resp 12, Pulse 64, Resp 12, Pulse ox 99%. Exam is unremarkable. What is your plan of care for Haley? Select all that apply.
Read Details