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Gender identity refers to:

You are working with a 9 year-old patient who has a diagnosis of attention deficit hyperactivity disorder (ADHD) who is prescribed Methylphenidate (Ritalin). You recognize that this medication can cause which of the following adverse effects?

Which of the following is an appropriate communication strategy when providing care for a pediatric patient who has been diagnosed with an Autism Spectrum Disorder?        

A 15-year-old is complaining of right ear pain and a feeling of fluid in his right ear for the past 3 days. He feels likes it is getting worse. He says his hearing is slightly decreased in the right ear in comparison to the left. He stated these symptoms started after he came back from a camping trip where he went swimming in a lake several times. Physical exam reveals a left ear that is WNL. His right ear is painful when the auricle is tugged. The ear canal is edematous and erythematous. Whitish exudate is present in the right ear, and due to the amount of exudate, the tympanic membrane was only partially visible. The portion seen was intact and nonerythematous. The most likely cause is: 

A 40 year, Ms. Zack, presents to the emergency room with a feeling that the walls and room are moving around even though she is not moving. Vertigo is confirmed.  The are various causes of vertigo.   Answer the following questions:   1- What are causes of benign positional vertigo and how would you be able to distinguish this cause of vertigo in comparison to other cause of peripheral type vertigo such as vestibular neuritis or Meniere’s disease? (3 points)   2- What are central causes of vertigo and what are clinical findings that would be more likely in central vertigo vs. peripheral vertigo? (2 points)    

Mark is 15 years old and plays sports.  He is complaining of anterior knee pain that has occurred intermittently over the past 2 to 3 months.  The pain worsens with walking up or down the stairs.  The pain decreases with rest.  Mark denies fever, weight loss, or systemic symptoms.  Physical exam reveals a tender, swollen tibial tuberosity in the affected knee.  Pain can be reproduced with resisted active extension and passive hyperflexion of the knee.  No effusion is noted.  The patient is not under acute distress.  What is the likely diagnosis? 

A parent is being taught how to swaddle their infant to prevent developmental hip dysplasia.  Which of the following represents correct teaching?

An 8 year old boy is brought in by his father and he is complaining of red, itchy eyes for 2 days. His father said it started in one eye and then got to the other. His eyes have a clear/mucous discharge. He denies eye pain but says he feels like he has sand in his eyes, he denies visual acuity change. He does have rhinitis, a productive cough with clear to yellowish phlegm, NO Fever. His father says a lot of kids at his school have been sent home with colds this past week. Allergies: NKDA Vital signs wnl General: WDWN 8 y/o boy in NAD Skin: pink, supple no lesions EENT: Canal clear, no vesicles; Tympanic membrane pearly gray, landmarks intact; nares with moderate amount whitish/tinge yellow discharge no oral lesions, no pharyngeal edema, Eyes: Bilateral edematous eyelids, clear, mucous drainage on lashes, conjunctiva erythematous, injected. Cornea and eyelid margins, no ulceration. PERRL bilaterally, OS 20/20, OD20/20. Fundoscopic well marginated discs, no AV nicking Neck: No lymphadenopathy, no goiter Heart: S1, S2 no gallops, rubs, murmurs Lungs: clear & equal bilaterally 1- What is the most likely type of conjunctivitis in this patient?   Discuss why you chose this answer. (3 points) 2- What is a common organisms in this type of conjunctivitis? How are infections acquired? What is the mode of transmission? (2 points)

A 48-year-old White male, Mr. Jansen, presents to the clinic for an evaluation of rapid onset of swelling of his left big toe and pain for the past 2 days. The pain is an 8 out 10 on a pain scale (0 indicates no pain and 10 indicates severe pain). The toe is red and warm. He denies injury/trauma to the toe or any decreased range of motion. Past medical history: hypertension Surgical history: none Hospitalizations: none Immunization history: up to date Social history: No smoking or illicit drug use. Drinks one or two beers a day and one or two cocktails on the weekends Medications: hydrochlorothiazide 25 mg orally once a day Allergies: no known drug allergies Vital signs: Height 5 feet, 9 inches (1.75 m), weight 198 lbs. (89.81 kg); temperature 98.7°F; pulse 72 beats/minute; respirations 16 breaths/minute; blood pressure 120/80 mmHg; pulse oximeter 99% on room air The review of symptoms is negative for fever, chills, nausea, vomiting, rash, headache, chest pain, palpitations, or shortness of breath.Physical examination reveals a well-nourished adult male without any acute distress. Significant physical findings include a hot, erythematous, and tender left first metatarsophalangeal joint. Pedal pulses are palpable bilaterally. Gait is steady. Skin is fully intact. Diagnosis:  Gout    Explain and describe the pathophysiology of this disorder (3 points). List all the history, signs/symptoms, risk that Mr. Jansen has that contribute to gout development and supports that he has gout (2 points).  

Mr. James, a 60-year-old man, is in the office today with his wife after being referred to a neurologist by his primary care provider. The patient reports having a resting tremor in his right hand and some stiffness in the right area for over a year now. He thought the tremors were related to nerves and would eventually resolve on its’ own. He also doesn’t like going to the doctor and his wife finally convinced him to go. On inspection you notice a pill-rolling movement in his right hand at rest that resolves with active movement of the hand. On further inspection the relative slowness of fine rapid movements of the right hand are noted along with rigidity to the right arm. On the basis of the patient’s history and physical findings, the neurologist diagnosis is early-stage Parkinson’s disease. Answer the following questions based on this case.   1- What are the key neurotransmitter defects in Parkinson and describe the usual role of the neurotransmitter? (2 points) 2- What areas of the brain are affected in Parkinson? (2 points) 3- Describe the symptoms that Mr. James has that are consistent with Parkinson’s disease. What are other symptoms that could occur? (1 point)