A thirty-six-year-old man presents with three months of fatigue and ten-pound unintentional weight loss. He reports multiple male and female sexual partners and inconsistent condom use. His complete blood count (CBC) shows mild normocytic anemia, mild thrombocytopenia, and mild lymphopenia. His basic metabolic panel (BMP) is normal. On examination, he has oral thrush but no lymph node enlargement or focal findings. Which test is the most appropriate to add now to help identify a unifying explanation for his symptoms and blood count abnormalities?

A twenty-seven-year-old man of Mediterranean ancestry develops dark urine and jaundice two days after starting a sulfonamide antibiotic. His father has a known red blood cell enzyme deficiency. What is the most appropriate first management step?

A sixty-six-year-old man with newly active Medicare coverage presents for his initial “Welcome to Medicare” preventive visit. He lives alone, recently tripped on a rug and caught himself on the counter, and takes five daily medications prescribed by different clinicians. He has no acute complaints and has already completed colon cancer screening within the past year. You plan to address routine immunizations and review his chronic disease screening, but you also want to be sure you fulfill the specific requirements of this initial Medicare preventive visit. Which action best reflects a core emphasis of the “Welcome to Medicare” visit?

A fifty-two-year-old woman has fatigue and mild shortness of breath. Complete blood count shows low hemoglobin, low mean corpuscular volume, and high red cell distribution width. Ferritin and transferrin saturation are very low. What is the most likely diagnosis?

A thirty-two-year-old woman reports six months of fatigue, unintentional weight loss, salt craving, and intermittent dizziness. Blood pressure is ninety-eight over sixty sitting with a further drop when standing. She has diffuse skin darkening on the hands and in the palmar creases. Basic metabolic panel shows mild low sodium and mild high potassium. She is stable in clinic without vomiting or acute distress. What is the most appropriate next diagnostic step?

A seventy-nine-year-old woman presents for an older adult annual visit. She lives alone and reports one fall in the past three months when turning quickly in her kitchen. She walks without a device at home but holds on to furniture. You perform a Timed Up and Go test: she needs 17 seconds to stand from a chair, walk 10 feet, turn, return to the chair, and sit. She needs to use her hands to push off and feels slightly unsteady when turning. Which management step is the most appropriate next action in primary care to reduce her future fall risk?

Conjunções. Explique brevemente por que os jovens estão lendo menos e discuta como textos como mangás e histórias em quadrinhos deveriam ser mais valorizados no contexto da formação leitora. Na sua resposta, utilize pelo menos oito conjunções coordenativas (por exemplo: e, mas, ou, porém, contudo, todavia, portanto, pois) e oito conjunções subordinativas (por exemplo: porque, embora, quando, enquanto, já que, assim que, para que, como), integrando todas de forma clara, natural e coerente.

Saudações. Que vocativos (expressões de saudação) usamos para começar e-mails argumentativos formais? (Marque todas as opções possíveis).    

Acentuação: Viagem sensorial. A partir do texto Viagem sensorial, selecione cinco palavras paroxítonas acentuadas. Explique por que essas palavras têm acentos. Exemplo: _____ é uma paroxítona que termina em _____.

Encerramento. Que expressões de despedida informais usamos para terminar cartas argumentativas? (Marque todas as opções possíveis).