Search results for "Physical exam"
MKSAP Quiz: preoperative evaluation for knee replacement
A 66-year-old man comes for a preoperative evaluation before total joint arthroplasty of the left knee. He has a 25-year history of rheumatoid arthritis. He has had progressive pain in his left knee with activity, which limits his ability to hike. The patient has similar pain in the right knee, but it is less severe. He reports no recent morning stiffness. He is able to climb two or three flights of stairs without chest pain or shortness of breath. He has no other medical problems and reports no additional symptoms. Medications are methotrexate and folic acid. Following a physical exam and lab tests, what is the next best step in management?
https://immattersacp.org/weekly/archives/2014/10/28/3.htm
28 Oct 2014
MKSAP Quiz: 5-day history of asymptomatic rash
A 68-year-old man is evaluated in the emergency department for a 5-day history of an asymptomatic rash on the upper back and upper arms. The lesions grew suddenly and are neither pruritic nor painful. The patient has had associated fevers. He has a myelodysplastic syndrome and has received intermittent erythrocyte transfusions, and he takes azacitidine. Following a physical exam, lab studies, and a skin biopsy, what is the most likely diagnosis?.
https://immattersacp.org/archives/2014/11/mksap.htm
1 Nov 2014
There's more to Medicare's Annual Wellness Visit
Clinicians and office staff can benefit from a refresher course about how to code claims correctly for prompt payment.
https://immattersacp.org/archives/2014/11/coding.htm
1 Nov 2014
Virtual visits pose real issues for physicians
There could be 1 million virtual health consultations done by phone or video by the end of 2014, with growth expected in 2015. Observers are weighing the benefits of access against the potential lack of an ongoing doctor-patient relationship.
https://immattersacp.org/archives/2014/11/virtual-visit.htm
1 Nov 2014
MKSAP Quiz: 2-year history of nonischemic cardiomyopathy with hypertension
A 55-year-old man is evaluated during a routine examination. He has a 2-year history of nonischemic cardiomyopathy. (Echocardiogram 2 years ago demonstrated a left ventricular ejection fraction of 35%.) He is feeling well and reports no shortness of breath; he walks 2 miles daily without symptoms. Medical history is remarkable for hypertension. Medications are lisinopril, carvedilol, and chlorthalidone. Following a physical exam, lab results, and an electrocardiogram, which calcium-channel blockers should be added to this patient's medical regimen?
https://immattersacp.org/weekly/archives/2014/11/04/3.htm
4 Nov 2014
MKSAP Quiz: rash on hands present for 6 weeks
A 40-year-old woman is evaluated for a rash on her hands that has been present for 6 weeks. This rash comes and goes throughout the year and has been present for many years, but never as severe as it is now. She also experiences itchy skin on her body. She had eczema as a child and currently has seasonal allergies. She is otherwise well and is currently taking no medication. Following a physical exam, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2014/11/11/3.htm
11 Nov 2014
MKSAP Quiz: mass in the right neck
A 38-year-old man is evaluated for a mass in his right neck that he first noticed 2 weeks ago while shaving. The patient also reports experiencing a pressure sensation when swallowing solid foods for the past year and daily diarrhea for the past 2 months. His personal medical history is unremarkable. His younger brother has nephrolithiasis, and his father died of a hypertensive crisis and cardiac arrest at age 62 years while undergoing anesthesia induction to repair a hip fracture. Following a physical exam, lab studies, and a chest radiograph, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2014/11/18/3.htm
18 Nov 2014
MKSAP Quiz: follow-up for a recent diagnosis of cirrhosis
A 50-year-old man is evaluated in follow-up for a recent diagnosis of cirrhosis secondary to nonalcoholic steatohepatitis. He has a history of asthma, type 2 diabetes mellitus, hyperlipidemia, and obesity. His current medications are inhaled fluticasone, montelukast, insulin glargine, insulin lispro, simvastatin, and lisinopril. Following a physical exam, lab studies, and upper endoscopy, what is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2014/11/25/3.htm
25 Nov 2014
MKSAP Quiz: evaluation for headache, eye pain, other visual problems
A 76-year-old woman is evaluated for a 1-day history of headache, left eye pain, nausea and vomiting, seeing halos around lights, and decreased visual acuity of the left eye. She has type 2 diabetes mellitus, hypertension, and atrial fibrillation. Medications are metformin, digoxin, metoprolol, hydrochlorothiazide, and warfarin. Following a physical exam and eye exam, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2014/12/09/3.htm
9 Dec 2014
MKSAP Quiz: abdominal pain of several months' duration
A 66-year-old man is evaluated for vague abdominal pain of several months' duration and a 10-kg (22-lb) weight loss. He drinks alcohol socially but does not smoke. The patient is otherwise well, has good performance status, and takes no medications. Following a physical exam, lab studies, and a CT scan, what is the most appropriate initial management of this patient?
https://immattersacp.org/weekly/archives/2014/12/16/3.htm
16 Dec 2014