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In the HPI using OLDCARTS, “worse after working on a computer for 2 hours” maps to:

Which documentation best reflects an appropriate Chief Complaint (CC)?

A 52-year-old man arrives to the clinic for evaluation of arthritis and leg swelling. The patient reports that the joint pains began 8 months ago. He has tried acetaminophen and ibuprofen without significant improvement. He reports the leg swelling began within the past 2 months and has gotten progressively worse. The patient’s medical history is significant for diabetes. His medications include metformin and aspirin. The patient works as an accountant. He smokes cigars socially. The patient’s temperature is 99°F (37.2°C), blood pressure is 130/78 mmHg, pulse is 70/min, and respirations are 14/min with an oxygen saturation of 98% on room air. Physical examination notes a deeply tanned appearing, overweight male with 2+ edema of bilateral lower extremities. Which of the following tumor markers is associated with a known complication of this patient’s condition?

A 24-year-old female presents for evaluation and reports experiencing fevers, drenching night sweats, and weight loss for past month. Patient notices an area in the right side of her neck that develops a “dull ache” after drinking alcohol. The patient reports that fevers range from 101.3F to 104.0F and occur almost daily. She has lost 15 pounds in past month unintentionally and has had several episodes of generalized pruritus with no associated skin lesions. On exam, there is a 1 x 2.5 cm firm LN in right cervical area palpable on exam; no other palpable adenopathy; no organomegaly. Initial laboratory test results include: normal CBC with diff, elevated ESR, normal CMP, and negative HIV test. What is the most likely diagnosis for this patient?

A 35-year-old woman presents to the emergency room with fatigue, dyspnea, and palpitations. A week earlier, the patient had received a dose of prophylactic cefotetan before an uncomplicated laparoscopic appendectomy. She has no other significant past medical history. She denies any family history of hereditary conditions. Her temperature is 98.1°F (36.7°C), blood pressure is 130/85 mmHg, pulse is 110/min, and respirations are 20/min. Jaundice and splenomegaly are noted on physical exam. Her hemoglobin is 7.1 g/dL, down from 13.2 g/dL 1 week ago. Additional laboratory tests are as follows:Leukocyte count: 7,000Platelet count: 300,000Mean corpuscular volume (MCV): 90Reticulocyte count: 9%Lactate dehydrogenase: 480 U/L (Normal: 140-280 U/L)Haptoglobin: 10 mg/dL (Normal: 41-165 mg/dL)Indirect bilirubin: 2.7 mg/dLD-dimer < 250 ng/mL (Normal: < 250 ng/mL)The peripheral blood smear shows reticulocytosis and microspherocytes. After appropriate therapeutic interventions, which of the following is the most appropriate next diagnostic test?

A 24-year-old male presents to his primary care physician for evaluation of recurrent fever, night sweats, and weight loss. The patient reports that he has been experiencing these symptoms for the past several weeks. After a complete physical exam and a series of laboratory and diagnostic tests, the patient undergoes an excisional lymph node biopsy (see image). The pathology report states that Reed-Sternberg cells are present. Staging evaluation determines that the patient has Stage IIB disease. Which of the following statements describes Stage IIB disease?    

A 25-year-old female presents to her primary care provider for evaluation of fatigue which has persisted for the past 6 months. She has tried multiple diets and sleep schedules to improve her condition, but none have succeeded. She has no significant past medical history. She is currently taking a multivitamin daily. Vital signs: T: 98.8°F (37.1°C), BP: 107/58 mmHg, HR: 90/min, RR: 13/min, and oxygen saturation is 98% on room air. Initial laboratory testing is obtained: Hemoglobin: 8 g/dL Hematocrit: 24% MCV: 118 Leukocyte count: 6,500 with normal differentialPlatelet count: 147,000 Physical exam is notable for decreased proprioception in the lower extremities. Which of the following is the most appropriate next step in management to confirm the diagnosis?

A 70-year-old female underwent a right total knee arthroplasty without complication. She was discharged to a rehab facility on post-operative day 3. Two days after her discharge from the hospital, she began experiencing pain and swelling of the right leg. Doppler ultrasound imaging at this time revealed a deep venous thrombosis in the right popliteal and tibial veins. The patient was re-admitted and started on an unfractionated heparin infusion. Five days later, doppler ultrasonography of the lower extremities revealed extension of the clot in the right lower extremity to include the common femoral, superficial femoral, popliteal, tibial, and saphenous veins. In addition, a thrombus was noted in the left common femoral vein as well. CBC showed a decrease in platelet count from 195,000/uL on admission to 83,000/uL. Which of the following is the pathophysiology of this patient’s presentation?

A 44-year-old female patient underwent elective cholecystectomy and has had multiple post-operative complications.  She has been admitted to the ICU. The nurse noted mild bleeding at the site of the IV line and the incision site during dressing changes. The patient also complained of bleeding from the gums and nose.  She was not suffering from any bleeding disorder prior to her hospitalization and she has  not received any packed red blood cell transfusions during this admission.  Initial lab results are as follows: (Abnormal results are in bold type)             PT (↑) and PTT (↑), Fibrinogen (↓), Fibrin degradation products (FDPs) (↑), Platelets (↓)             Peripheral Blood Smear:  evidence of RBC fragments and decreased number of platelets.             Which of the following conditions is the most likely diagnosis for this patient?

A 34-year-old woman presents to the emergency department with sudden-onset dark urine and pallor. She also complains of back pain and fatigue. She has a history of celiac disease. Due to inconsistent adherence to a gluten-free diet, the patient has recently developed dermatitis herpetiformis. She was started on dapsone 2 days ago. Labs are drawn, as shown below:WBC count: 11,000Hemoglobin: 8.0 g/dLPlatelets: 200,000 PT/PTT: normalSerum:Aspartate aminotransferase (AST): 15 U/LAlanine aminotransferase (ALT): 12 U/LTotal bilirubin: 3.8 mg/dLDirect bilirubin: 0.2 mg/dLHaptoglobin: 36 g/dL (normal range: 50-200 g/dL)Lactate dehydrogenase (LDH): 125 U/LA peripheral smear shows red blood cells with semicircular portions removed from the cells’ periphery (‘bite cells’). Heinz bodies are seen with methylene blue staining. Which of the following is the most likely diagnosis?