A 65-year-old man presents to the emergency room with sharp chest pain and shortness of breath. He notes that he has been recovering from a gastrointestinal virus for the past several days, but that the chest pain was not present on previous days. During the physical exam, he notes that the pain seems to be decreased when he is seated and leaning forward. His systolic blood pressure is 150 mmHg on expiration and 141 mmHg on inspiration. An EKG is shown in Figure A. Assuming that the cause of this patient's cardiac condition is related to his recent viral illness, which of the following is the most appropriate treatment?

A 55-year-old man with no significant past medical history p...

Sorry, only PEAK Subscribers can view this question

A 62-year-old Nigerian woman arrived 2 days ago to the US to visit her adult children from Nigeria. She is now brought to an urgent care center by her daughter for leg pain. Her right leg has been painful for 24 hours and is now causing her to limp. She denies any fevers, chills, or sweats and does not remember injuring her leg. She tells you she takes medications for hypertension and diabetes and occasionally for exertional chest pain. She has not had any recent chest pain. The right leg is swollen and tender. Flexion of the right ankle causes a worsening of the pain. Doppler ultrasonography reveals a large clot in a deep vein. Which of the following is the most appropriate course of action?

A 57-year-old otherwise healthy male presents to his primary...

Sorry, only PEAK Subscribers can view this question

A 47-year-old woman presents to the emergency department wit...

Sorry, only PEAK Subscribers can view this question

A 49-year-old man presents to his primary care physician for...

Sorry, only PEAK Subscribers can view this question

A 34-year-old male is brought to the emergency department. H...

Sorry, only PEAK Subscribers can view this question

A 57-year-old man presents to the emergency department with ...

Sorry, only PEAK Subscribers can view this question

A 37-year-old man presents to the emergency department for a...

Sorry, only PEAK Subscribers can view this question

A 75-year-old Caucasian man presents to the emergency depart...

Sorry, only PEAK Subscribers can view this question

A 16-year-old male high school basketball player presents to his primary care provider with complaints of fatigue and night sweats for the past month. He also recalls that, after suffering a hand laceration during a game, the nurse had a difficult time achieving hemostasis. Otherwise, the patient has no other medical problems. Three weeks later, the patient is admitted to the ICU with decreased level of consciousness. His temperature is 98.7°F (37.1°C), blood pressure is 96/72 mmHg, pulse is 110/min, respirations are 18/min, and oxygen saturation is 96% on room air. Lab tests are as follows: CBC: Hemoglobin: 9 g/dL Hematocrit: 35 % Leukocyte count: 10,000/mm^3 with normal differential Platelet count: 75,000/mm^3 Prothrombin time: 18 seconds Partial thromboplastin time: 55 seconds The findings in Figure A are seen on examination of the patient’s skin. Peripheral blood smear reveals the cell morphologies seen in Figure B. What is the underlying cause of this patient’s presentation?

A 63-year-old man undergoes uncomplicated laparascopic cholecystectomy for acute cholecystitis and is admitted to the surgical ward for postoperative management. On postoperative day 1, routine laboratory studies reveal an increase in serum creatinine to 1.46 mg/dL from 0.98 mg/dL before the operation; BUN is 37 mg/dL, increased from 18 mg/dL on prior measurement; K is 4.8 mEq/L and CO2 is 19 mEq/L. The patient has an indwelling urinary catheter in place, draining minimal urine over the last few hours. Which of the following is the most appropriate next step in management?

Health officials are considering a change be made to the interpretation of the tuberculin skin test that will change the cut-off for a positive purified protein derivative (PPD) from 10 mm to 15 mm for healthcare workers. Which of the following can be expected as a result of this change?

A 74-year-old female with a history of lung adenocarcinoma s...

Sorry, only PEAK Subscribers can view this question

A 57-year-old immigrant from Nigeria presents to the emergen...

Sorry, only PEAK Subscribers can view this question

A 32-year-old woman presents to clinic complaining of pelvic pain and heavy menstrual bleeding for the past 2 years. The patient reports that her last menstrual period was 1 week ago and she soaked through 1 tampon every 1-2 hours during that time. She does not take any medications and denies alcohol and cigarette use. She is currently trying to have a child with her husband. She works as a school teacher and exercises regularly. Her temperature is 97.0°F (36.1°C), blood pressure is 122/80 mmHg, pulse is 93/min, respirations are 16/min, and oxygen saturation is 99% on room air. Physical examination reveals an enlarged, irregularly-shaped uterus palpable at the level of the umbilicus. Laboratory studies are ordered as seen below. Hemoglobin: 9.0 g/dL Hematocrit: 29% MCV: 70 fL Leukocyte count: 4,500/mm^3 with normal differential Platelet count: 188,000/mm^3 Urine: hCG: Negative Blood: Negative Leukocytes: Negative Bacteria: Negative Which of the following is the most effective treatment for this patient?

A 33-year-old man is brought into the emergency department with fever, lethargy, and confusion. He is a cachectic man in acute distress, unable to respond to questions or follow commands. His friend confides that the patient has been sexually active with multiple male partners and was diagnosed with HIV several months ago, but was lost to follow up. Based on prior records, his most recent CD4 count was 65 cells/uL. Which of the following is the most appropriate next step in management?

A 67-year-old woman is brought to the emergency room after complaining of back pain with a gradual loss of sensation in her lower extremities. She was recently diagnosed with radiosensitive metastatic breast cancer and was scheduled to receive chemotherapy and palliative surgery. Her temperature is 99.0°F (37.2°C), blood pressure is 133/81 mmHg, pulse is 82/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam is notable for decreased sensation bilaterally over the patient's lower extremities. She demonstrates 2/5 strength of leg extension on the left and 1/5 on the right which is slightly worse than her baseline neurological exam taken 2 months ago. Pain to her lumbar region worsens with coughing. An initial CT scan of the spine does not demonstrate any unstable fractures of the spine. A MRI of the spine is ordered and pending. Which of the following is the most appropriate next step in management?

A 32-year-old G1P0 presents to the antenatal testing unit at...

Sorry, only PEAK Subscribers can view this question

A 36-year-old G3P2002 at 34 weeks gestation presents to the ...

Sorry, only PEAK Subscribers can view this question