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A 73 year old male presents to the office for follow-up to his systolic CHF. You are explaining to his family that he has New York Heart Association stage III heart disease? What is the most accurate list of medications that he should be taken?

A 37 year old female presents to the office for evaluation. She reports feelings of hopelesness, depressed mood, decreased appetite and sleep. Her employer indicated that she needed to get help because she is not completing her tasks at work and has been calling in sick too much. She feels fatigued and has trouble concentrating. She reports that she has been feeling this way for the last 4 weeks. She did not seek help because 2 months ago she was feeling great. She went out gambling with her friends, participated in a group cocaine party and staying up all night. What is her likely diagnosis and treatment plan?

Which of the following is considered a clinical red flag for a patient who presents with back pain?

A 23 year old male presents to the office complaining of bloody stool. He reports that symptoms started about 1 week ago. He has crampy abdominal pain throughout the day. He denies fever, chills, nausea or vomiting. He reports that this is the 3rd time he has had these symptoms in the past 6 months. He denies constipation. He has not seen any relationship with his diarrhea to the food that he eats. He is sexually active with females only and has never had anal sex. On DRE you note occult blood and diffuse tenderness in the lower abdomen. You have completed baseline labs with CBC/CMP, ESR and CRP. You suspect that he has inflammatory bowel disease, what are your next steps in evaluation?

A 25 year old male presents to the office for malaise, sore throat and fever. He reports that his symptoms started about 3 days ago. On exam, you note submental and submandibular adenopathy and bilateral exudates on the tonsils with an erythematous posterior pharynx. His temperature is 101.4 and the remainder of his vitals are normal. He denies cough, congestion or oral sex. His mono test is negative.  What is the best treatment plan for him? 

A 28 year old male presents to the office for complaints of a rash on the palms of his hands and the soles of his feet. He reports it started about 1 week ago and he has used hydrocortisone on it without any resolution. He reports that he has felt tired and weak and has had a fever of 101.4 on and off for the past week. He denies headaches, chills, neck pain, nausea, vomiting or diarrhea. He denies smoking, etoh and drugs. He is sexually active with 2 other male partners in the past 1 month and 6 in the past year. He notes that he did have a lesion on his penis a 3-4 weeks ago which has resolved. On exam, you note some tender adenopathy in the inguinal nodes as well as bilateral supraclavicular nodes. He appears tired and in the office he has a temperature of 100.2. He has negative Brudinski and Kernig signs. What is his likely diagnosis and treatment plan?

  A 59 year old male presents to your office as a new patient. He indicates that he has a history of hypertension and high cholesterol. He reports that he was admitted to the hospital about a year ago for some crushing chest pain and shortness of breath “alot of stuff went on, but I don’t really remember it all”. He reports that he was in the ICU for a few days and had a stent placed. He will get you his old records for further review. He indicates that he takes a combination medication called Prinzide (lisinopril/HCTZ), atorvastatin and an aspirin. You check an EKG and it shows q waves and LVH. His vital signs are T: 98.6, HR 92, RR 16, BP 150/92. What other medication should he be started on before he leaves the office?

A 45 year old female presents to your office with complaints of diarrhea, weight loss and sweating for the past 3 months. Her vital signs are as follows:  HR 115, BP 119/82., RR 12, SPO2 99% RA you note that her thyroid is enlarged.  You would like to evaluate her for a thyroid condition.  You order a TSH which is abnormal and then you order a Free T3 & T4.   Here are your lab results: TSH 0.2 mIU/L (normal  0.4-6 miU/L) Free T4 8.6 ng/dL (normal 0.7-2.0 ng/dl) Free T3 4.3 pg/dL (normal 2.3-4.2 pg/dL) Based on the above, the next logical step would be to order which of the following?

A 54 year old male presents to the office with diffuse right sided abdominal pain. He indicates that he is nauseated and has had 3 bouts of vomiting over the past 2 days. He reports that he recently went to Argentina for a humanitarian trip with his job and started getting sick on the way home.  He feels tired, weak and his wife mentioned that his skin coloring is a little yellowish. He is sexually active with his wife only and denies any transfusions or IV drug use. What lab test would be the most appropriate for this patient? 

Aoi is a second-year business student at Mason. She has wonderful English skills and her English was the best in her high school in her home country. She is currently writing a business memo for one of her classes. Though her English is good, she sometimes struggles with academic English, especially when it comes to writing. Her professor has been giving her grades of C and C- for her writing. She is so frustrated with all of this.  Her friend, Birgit, shows Aoi her business memo. Aoi needs better grades, therefore, she is tempted to adjust her memo to make sure her English is correct and copy Birgit’s academic writing in her memo. What should Aoi do to make certain she does not violate the honor code?