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While doing a fundoscopic exam on Mr. Stephens, you find cotton wool spots.  Cotton wool spots result from:

Read the following excerpt from T.S. Eliot, The WasteLand. Then answer the following two questions. 1. The Burial of the DeadApril is the cruellest month, breedingLilacs out of the dead land, mixingMemory and desire, stirringDull roots with spring rain.Winter kept us warm, coveringEarth in forgetful snow, feedingA little life with dried tubers.Summer surprised us, coming over the StarnbergerseeWith a shower of rain; we stopped in the colonnade,And went on in sunlight, into the Hofgarten,And drank coffee, and talked for an hour.Bin gar keine Russin, stamm’ aus Litauen, echt deutsch.And when we were children, staying at the archduke’s,My cousin’s, he took me out on a sled,And I was frightened. He said, Marie,Marie, hold on tight. And down we went.In the mountains, there you feel free.I read, much of the night, and go south in the winter.What are the roots that clutch, what branches growOut of this stony rubbish? Son of man,You cannot say, or guess, for you know onlyA heap of broken images, where the sun beats,And the dead tree gives no shelter, the cricket no relief,And the dry stone no sound of water. OnlyThere is shadow under this red rock,(Come in under the shadow of this red rock),And I will show you something different from eitherYour shadow at morning striding behind youOr your shadow at evening rising to meet you;I will show you fear in a handful of dust.                     Frisch weht der Wind                      Der Heimat zu                      Mein Irisch Kind,                      Wo weilest du?‘You gave me hyacinths first a year ago;‘They called me the hyacinth girl.’—Yet when we came back, late, from the Hyacinth garden,Your arms full, and your hair wet, I could notSpeak, and my eyes failed, I was neitherLiving nor dead, and I knew nothing,Looking into the heart of light, the silence.Oed’ und leer das Meer.Madame Sosostris, famous clairvoyante,Had a bad cold, neverthelessIs known to be the wisest woman in Europe,With a wicked pack of cards. Here, said she,Is your card, the drowned Phoenician Sailor,(Those are pearls that were his eyes. Look!)Here is Belladonna, the Lady of the Rocks,The lady of situations.Here is the man with three staves, and here the Wheel,And here is the one-eyed merchant, and this card,Which is blank, is something he carries on his back,Which I am forbidden to see. I do not findThe Hanged Man. Fear death by water.I see crowds of people, walking round in a ring.Thank you. If you see dear Mrs. Equitone,Tell her I bring the horoscope myself:One must be so careful these days

Linda has come in for follow-up on her recent labs. She is 66 inches in height, weighing 200 pounds.  You are diagnosing her with type 2 diabetes mellitus (DM) with a HgbA1C of 7.2 . Her fasting plasma glucose level is 198 mg/dL. What is the best initial treatment?

A 45 y/o female comes to the urgent care with a short event this morning of facial droop, inability to talk and left sided weakness.  Symptoms have resolved as of now.  She has no past medical history and only takes OCPs.  What diagnosis are you considering for her?

What is the name of the generalized seizure that presents as a sudden, stiffening of muscles, often causing the patient to fall to the ground, and is followed by the patient lying rigid on the ground?     

*What is the average age of menopause?

*A 16-year-old male patient presents to your office with a two week complaint of sneezing, clear nasal discharge, and fatigue. Following a thorough history and physical you determine he has allergic rhinitis. Which of the following would support your diagnosis?

As providers/prescribers, what is expected of us for antibiotic stewardship to help reduce antibiotic resistant microbes?

    You are reviewing the chart of Mr. Janssen, a 65 year old man. At his last visit, he complained of chest pain and shortness of air, occurring when he would walk fairly long distances.  They resolved with rest. Today, he reports the episodes are still occuring, but have changed, as they are sometimes associated with nausea and vomiting.  He is still able to relieve the symptoms with rest, however. With this new information, you believe that his diagnosis is likely:

Depression is one of the most common disorders in the primary care setting.  However, depression is often under diagnosed, especially in the elderly.  Which of the following is true concerning components of depression in elderly persons?