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A 4 month old presents to the PMD office with pale skin, poor growth, enlarged palpable liver. In reviewing the history with the family the father expresses they are of Mediterranean decent. You suspect this infant is anemic presenting with signs of

muscular layer of the heart 

decreased supply of oxygenated blood to a body part due to circulatory obstruction

WBC

the rupture of an artery 

Case Description: 55 year old presents 3 weeks after L total knee replacement. They have been walking without a cane for about a week but still have some pain in the knee. Their ROM is nearly full at this point per the home PT. Pt admits in the break from home PT to outpatient that they didn’t do their home program as much and may have lost some range of motion. They present to your outpatient clinic for an initial assessment. 

Please use this area to document the written exam portion of your final exam. Document your interview as you would in a patient’s note/chart.

heart valve with three flaps 

Case Description: 33 year old presents with left shoulder pain after a rigorous bout of gardening 5 days ago. The pain was quite intense the first few days but is now moderate. They are a physician and having a hard time at work. They are presenting to your outpatient clinic for assessment.                                                                                             

Why should beta blockade be started greater than 1 day prior to noncardiac surgery?