A 63-year-old man treated for hypertension reports lightheadedness when standing. Seated BP is 128/72 mm Hg and HR 66/min. After standing for 3 minutes, BP is 102/64 mm Hg and he becomes symptomatic. Which issue should be addressed first?
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A 46-year-old woman was treated for acute bacterial rhinosin…
A 46-year-old woman was treated for acute bacterial rhinosinusitis 5 days ago. Facial pain and nasal drainage have improved, but she still reports nasal congestion. She has no fever, orbital symptoms, severe headache, or neurologic findings. What is the most appropriate next step?
A 65-year-old patient with COPD has increased dyspnea, sputu…
A 65-year-old patient with COPD has increased dyspnea, sputum volume, and sputum purulence for 3 days. She is stable for outpatient treatment. Which treatment plan is most appropriate?
A 46-year-old man has no known atherosclerotic cardiovascula…
A 46-year-old man has no known atherosclerotic cardiovascular disease. His LDL-C is 212 mg/dL on two separate measurements. Which management approach is most appropriate?
A 62-year-old woman presents with unilateral calf swelling a…
A 62-year-old woman presents with unilateral calf swelling and tenderness. Compression ultrasonography is negative, but clinical suspicion for deep vein thrombosis remains high. Which action is most appropriate?
A 59-year-old renal transplant recipient develops a rapidly…
A 59-year-old renal transplant recipient develops a rapidly enlarging hyperkeratotic lesion on the dorsal hand. The lesion has recently ulcerated. What is the most appropriate next step?
A 61-year-old patient is struck in the eye by a ball. Visual…
A 61-year-old patient is struck in the eye by a ball. Visual acuity is decreased and examination reveals blood layering in the anterior chamber. Which action is most appropriate?
A 74-year-old man has numerous rough, erythematous lesions a…
A 74-year-old man has numerous rough, erythematous lesions across a chronically sun-damaged scalp. Several individual lesions were previously treated with cryotherapy, but new lesions continue to appear throughout the area. Which management approach is most appropriate?
A 42-year-old woman has intensely pruritic papules involving…
A 42-year-old woman has intensely pruritic papules involving the wrists, finger webs, and waistband. Her spouse recently developed similar symptoms. Which management plan is most appropriate?
A healthcare worker has a positive interferon-gamma release…
A healthcare worker has a positive interferon-gamma release assay. He is asymptomatic and chest imaging shows no evidence of active tuberculosis. What is the most appropriate next step?