Mr. Ralston is being seen for progressive dyspnea and cough….

Mr. Ralston is being seen for progressive dyspnea and cough.  He reports some clear mucous production and you notice he is thin and has a barrel chest. He said he used to take an inhaler but has been out for some time and has been using his grandson’s albuterol prn but it doesn’t really help.  On exam, he is breathing with pursed lips and has fine crackles with auscultation. You perform PFTs in the office and he has: Normal FVC (forced vital capacity) Increased Residual Volume Normal TLC (Total Lung Capacity) Decreased FEV1/FVC ratio What diagnosis do you suspect?

You are seeing Mr. Green, a 67 year old male, for the first…

You are seeing Mr. Green, a 67 year old male, for the first time. He has had Type 2 diabetes for the past 16 years.  Although he has been on insulin for 2 years, he does not maintain optimal control, as his A1C remains 8-9 most of the time.  You see on his chart was prescribed an ACE inhibitor 2 year ago, after being found to have microalbuminuria.  This was likely done as Mr. G is at risk for:

Larry Baxter, 59 y/o patient presents to the clinic with gen…

Larry Baxter, 59 y/o patient presents to the clinic with general complaints of fever, chills, low back pain, accompanied with urinary frequency, urgency and dysuria.  Last night he had to get up several times to urinate.  Overall he just doesn’t feel well.  When performing a prostate examination, you note a tender, warm prostate. What do you suspect?