Betty, age 40, has had type 1 diabetes for 20 years and take…

Betty, age 40, has had type 1 diabetes for 20 years and takes a combination of NPH and regular insulin every day. She comes to the office because she has developed a severe upper respiratory infection with chills, fever and production of yellow sputum. Because of her acute respiratory infection, you know that Betty is likely to require: 

Margaret is an 80 y.o. female, who presents to the internal…

Margaret is an 80 y.o. female, who presents to the internal medicine clinic for a 1-week follow-up from her recent hospitalization following a fall. She was treated for a catheter-associated UTI with a 7-day course of trimethoprim-sulfamethoxazole (Bactrim). Recent chem 7 reveals potassium level 5.2, and calculated creatinine clearance < 30. According to the AGS Beers Criteria®, which of the following medications would you also be concerned about given this antibiotic choice and risk of hyperkalemia when used concurrently?

Kathleen is an 83-year-old woman who has recently fallen thr…

Kathleen is an 83-year-old woman who has recently fallen three times in 2 weeks. Fortunately, her only injuries have been some mild soreness, but her daughter insisted she see the nurse practitioner to figure out why she is falling. Kathleen’s review of systems is negative except for the falls. Her gait, strength, timed get up and go, cardiac and respiratory exam are unremarkable. The NP’s initial diagnostic work up should include:

A 66-year-old male arrives at the office today without an ap…

A 66-year-old male arrives at the office today without an appointment. He appears quite anxious and pale and is complaining of an aching pain across his sternum that radiates to his L jaw and down the L arm at times.  It started about an hour ago and awakened him from sleep. He took an anti-acid and acetaminophen, but they did not seem to help. His blood pressure is 160/90, and HR is 98. An ECG shows normal sinus rhythm with 2-mm ST segment elevations in leads II, III, and AVF. What do you suspect?