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A 78-year-old female patient with a history of hypertension, CHF, CAD, osteoarthritis, and mild cognitive impairment has been diagnosed with atrial fibrillation. The CHADS2-VASc scoring system is one validated measure to help estimate the annual risk of having a cerebrovascular accident with atrial fibrillation. ATRIAL FIBRILLATION: THE CHA2DS2-VASc SCORE Condition Points Patient Score CONGESTIVE HEART FAILURE Yes      1 point No       0 point HYPERTENSION Yes      1 point No       0 point AGE  >75     2 points 65-74 1 point

In order to make a diagnosis of dementia, delirium must be ruled out. However, patients with dementia are at increased risk of delirium and may have both diagnoses. Which of the following is more likely associated with dementia than delirium?

You are evaluating a 70-year-old male patient for syncope. Auscultation of his heart reveals a mid-systolic ejection murmur heard best to the right of the sternum in the second intercostal space. The harsh crescendo-decrescendo murmur is heard best with the diaphragm and it radiates to the neck. Which of the following murmurs does this represent? 

According to the American Society of Clinical Oncology (ASCO.org), melanoma accounts for about 1% of all skin cancers in the U.S., but it causes most of the deaths from skin cancer. Risk factors for malignant melanoma include:

Parkinson’s disease is a slowly progressive neurodegenerative disease.  The diagnosis of Parkinson’s disease is made by clinical evaluation and consists of a combination of 6 cardinal features. Which of the following is NOT a cardinal feature of Parkinson’s disease:

Describe how the graph of y= x2 can be transformed to the graph of the given equation. y = (x – 15)2 (5 points)

Describe how the graph of y= x2 can be transformed to the graph of the given equation. y = (x – 6)2 (5 points)

f(x) = 7x + 7, g(x) = 6×2 Find (fg)(x). (5 points)

Which of the following is not a domain in the entrepreneurial ecosystem?

Your next patient is 22 year old male who has been experiencing increasing GI symptoms over the past 6 months.  He has relapsing and remitting abdominal pain and cramping, migratory arthralgia, and chronic bloody diarrhea.  He first thought it may have been some food he ate at a restaurant with friends, then he was very worried about hemorrhoids.  He has recently lost some weight without trying.   Now he notes these symptoms without an obvious source. What is most likely the cause of these symptoms?