Author: Anonymous

A 34-year-old female presents for a physical exam. She is new to the practice and enrolled because she and her family had recently moved to the area and her last physical was more than 1 year ago. On review of her history, the patient has had 2 normal vaginal deliveries and is currently on no oral contraceptive medication, as her husband has had a vasectomy. She has had no chronic medical problems. Her only medications are a multivitamin and Vitamin E. On review of her records, you note that she had a relatively normal fasting lipid profile performed 5 years ago, is up to date on her Tetanus shot, and has had normal Pap smears over the past 5 years. The records also seem to indicate that she has gained about 10 lbs in weight over the past year. Her physical exam is within normal; she is about 20% overweight. You ask the patient to do a repeat fasting lipid profile and the values are as follows: Total cholesterol is 342 mg/dL (normal under 200) LDL Cholesterol 225 mg/dL (normal 60-160) HDL Cholesterol 75 mg/dL (normal 30-80) Triglyceride level 210 mg/dL (normal under 150) What would be the most appropriate next step in the diagnostic evaluation of this patient?

A 24-year-old man is referred to an endocrinologist for paroxysms of headaches associated with elevated blood pressure and palpitations. He is otherwise healthy, although he notes a family history of thyroid cancer. His physical examination is significant for the findings shown in Figures A, B, and C (see images). His thyroid is normal in size, but there is a 2.5 cm nodule palpable in the right lobe. On further workup, it is found that he has elevated plasma-free metanephrines and a normal TSH. Fine-needle aspiration of the thyroid nodule stains positive for calcitonin. The endocrinologist suspects a genetic syndrome. What is the most likely inheritance pattern?

A 55-year-old female with a 15-year history of Type II diabetes comes to your office for follow up of her diabetes. Her spot albumin/creatinine ratio was 100 mg/g 4 months ago and was confirmed at 100 mg/g yesterday, consistent with stable microalbuminuria. Her urinary analysis shows no cells, casts, or blood. Her creatinine is 0.7mg/dl and her estimated glomerular filtration rate is 95 ml/min (normal range). Which of the following medications should you prescribe to help prevent her progression from micro to macroalbuminuria and to help prevent progressive decline in glomerular filtration rate?

A 30-year-old man presents to your clinic complaining of excessive thirst and frequent urination for the past few months. Urine testing reveals a low urine osmolarity, which fails to increase after subjecting the patient to a water deprivation test and injection of desmopressin. Further into the encounter, the patient reveals that he has been on a mood stabilizer for bipolar disorder for several years. Which of the following is the most likely cause of his polyuria?

A 48-year-old female presents to the clinic due to 3 weeks of increased thirst and increased urination. She has a history of obesity, hypertension and depression and has smoked a pack of cigarettes daily for the past 28 years. Her current medications include lisinopril and sertraline. T 98.5°F, BP 148/90 mmHg, HR 84/min, and RR 15/min. Her physical exam is normal, and her laboratory values are as follows:   Serum: Na+: 140 mEq/L K+: 4.4 mEq/L HCO3-: 21 mEq/L BUN: 38 mg/dL Creatinine: 1.1 mg/dL Glucose: 215 mg/dL Which of the following is the most appropriate screening test for nephropathy in this patient?

 A 22-year-old female presents with urinary frequency. Her BMI is 41. A urinalysis is positive for glucose. Her random blood sugar is 257 mg/dL, hemoglobin A1c is 8.5%, and C-peptide is 1.5 ng/mL. She is diagnosed with type 2 diabetes; diet and exercise are recommended. What is the drug of choice for managing her diabetes?

A 65-year-old male is noted by his family to have developed a short shuffling gait and difficulty getting up from a seated position.  On physical examination, you note a resting tremor and rigidity of the joints with passive range of motion.  Based on these findings, which of the following conditions is the most likely diagnosis for this patient?

What does postnatal mean?

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Q5. What command can be typed to increase the display thickness of lines on screen (without changing their actual plotted weight)?