A 57-year-old man presents to his primary care physician for...

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A 22-year-old female is hospitalized with fever and hypotension refractory to fluid resuscitation. Her vital signs are as follows: T 39.0 C, P 110, BP 86/52, RR 12, SpO2 98%. Physical exam reveals diffuse macular erythroderma (Figure A) and the following findings of the conjunctiva (Figure B) and oral cavity (Figure C). She complains of muscle aches as well as diarrhea for the past 3 days. She denies any recent travel or new sexual partners. She had her last menses 4 days ago and always uses a tampon. What is the most likely organism to cause this patient’s presentation?

A 45-year-old male is presenting for routine health maintenance. He has no complaints. His pulse if 75/min, blood pressure is 155/90 mm Hg, and respiratory rate is 15/min. His body mass index is 25 kg/m2. The physical exam is within normal limits. He denies any shortness of breath, daytime sleepiness, headaches, sweating, or palpitations. He does not recall having an elevated blood pressure measurement before. Which of the following is the best next step?

A 23-year-old man presents to his pediatrician for a wellnes...

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A 20-year-old student has an appointment with his primary ca...

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A 55-year-old man presents to the emergency department for s...

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A 64-hour-old baby girl is being evaluated for discharge. Sh...

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A 66-year-old woman presents to the emergency department wit...

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A 36-year-old African American woman G1P0 at 33 weeks gestat...

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A 42-year-old man presents to the emergency department with ...

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A 32-year-old man presents to his primary care physician for...

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A 64-year-old man presents to the clinic complaining of low ...

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A 5-year-old boy presents to his pediatrician along with his...

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

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A 56-year-old man is brought to the clinic by his wife for c...

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A 62-year-old male with a history of chronic lymphocytic leukemia is admitted to the hospital for chemotherapy with fludarabine after transformation into prolymphocytic leukemia. Three days later, the nurse calls you because the patient is vomiting. The patient reports he is nauseous and he feels weak. On physical exam, he is ill-appearing, and you appreciate diffuse, bilateral lymphadenopathy, symmetrical muscle weakness, and bilateral areflexia. Labs are drawn and an electrocardiogram (EKG) is obtained, which is shown in Figure A. In addition to cardiac stabilization, which of the following is the best next step in management?

An 18-year-old college student presents to the student healt...

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A 23-year-old man presents to the emergency department with ...

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A 33-year-old man presents to his primary care physician for...

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A 27-year-old man presents to the emergency department with ...

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A 23-year-old woman with a past medical history of amphetami...

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A 17-year-old girl is brought to her pediatrician by her mot...

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A 17-year-old girl presents to her primary care physician with a concern for a puffy cheek. She has noticed she has had a puffy cheek for the past month despite exercising more often and eating a healthy diet. The patient states she is an otherwise healthy student, does not smoke, and is not sexually active. Her temperature is 97.9°F (36.6°C), blood pressure is 114/74 mmHg, pulse is 105/min, respirations are 13/min, and oxygen saturation is 98% on room air. Physical exam is notable for a healthy young woman with a nontender abdomen. Exam reveals the finding in Figure A as well as poor dentition. Her BMI is 26 kg/m^2 and she has normal development for her age. Laboratory values are ordered as seen below. Hemoglobin: 10 g/dL Hematocrit: 30% Leukocyte count: 12,900/mm^3 with normal differential Platelet count: 191,000/mm^3 Serum: Na+: 139 mEq/L Cl-: 100 mEq/L K+: 3.0 mEq/L HCO3-: 29 mEq/L BUN: 23 mg/dL Glucose: 99 mg/dL Creatinine: 1.2 mg/dL Ca2+: 10.2 mg/dL Which of the following is the most likely diagnosis?

A 32-year-old woman presents to the emergency department due...

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A 32-year-old G1P0 woman presents to her obstetrician for a ...

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A 75-year-old man with coronary artery disease and mitral valve stenosis status-post coronary artery bypass graft and mitral bioprosthetic valve replacement is evaluated in the intensive care unit. His postsurgical course was complicated by ventilator-associated pneumonia and bilateral postoperative pleural effusions requiring chest tubes. He has been weaned from the ventilator and has had his chest tubes removed but has required frequent suctioning to minimize aspirations. He has been dependent on a percutaneous gastrostomy tube for enteral nutrition for the past four weeks. He is currently on aspirin, carvedilol, atorvastatin, ceftazidime, and pantoprazole. He has a history of prostate cancer status post radical prostatectomy. His temperature is 96°F (35.6°C), blood pressure is 95/55 mmHg, pulse is 50/min, and respirations are 20/min. On physical exam, he is not alert and oriented but responds with moans when stimulated. His laboratory data are listed below: Serum: Na+: 145 mEq/L Cl-: 110 mEq/L K+: 3.4 mEq/L HCO3-: 26 mEq/L BUN: 10 mg/dL Glucose: 112 mg/dL Creatinine: 1.4 mg/dL Thyroid-stimulating hormone: 10 µU/mL Ca2+: 11.1 mg/dL PO4-: 1.0 mg/dL AST: 6 U/L ALT: 10 U/L Albumin: 2.5 mg/dL Lactate dehydrogenase: 200 U/L (140-280 U/L) Haptoglobin: 150 mg/dL (30-200 mg/dL) 1,25-(OH)2 D3: 10 pg/mL (15-75 pg/mL) Parathyroid hormone: 9 pg/mL (10-60 pg/mL) Leukocyte count: 10,000 cells/mm^3 with normal differential Hemoglobin: 9 g/dL Hematocrit: 30 % Platelet count: 165,000 /mm^3 His electrocardiogram and chest radiograph are shown in Figures A and B. What is the most likely cause of his hypercalcemia?

A 26-year-old man presents to the office complaining of “enl...

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A 28-year-old woman with a history of type 2 diabetes mellitus presents to her gynecologist complaining of 4 days of vaginal itching and burning. Gynecological exam reveals vulvar and vaginal erythema as well as vaginal discharge that resembles cottage cheese. Vaginal wet-mount with KOH prep is shown in Figure A. What treatment should this patient receive?

A 38-year-old G1P0 woman presents to her obstetrician for a ...

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A study is being conducted on depression using the Patient H...

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A 65-year-old man presents to his primary care physician for...

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A 47-year-old man presents to his ophthalmologist for abnorm...

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A healthy, 32-year-old man presents to the clinic concerned ...

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The the mean, median, and mode weight of 37 newborns in a ho...

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A study is performed to assess the intelligence quotient and...

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In 2013 the national mean score on the USMLE Step 1 exam was...

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A study is being conducted on depression using the Patient H...

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A 71-year-old man presents to the emergency department becau...

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A 24-year-old woman arrives to an urgent care clinic for "ey...

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A 27-year-old man presents to the emergency department due t...

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A 44-year-old woman presents to her primary care physician f...

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