Search results for "Physical exam"
MKSAP Quiz: Recent onset of fatigue and muscle weakness
A 52-year-old man is evaluated for recent onset of fatigue and muscle weakness. The patient further reports nocturia and polyuria over the past 4 weeks and a 6-kg (13.2-lb) weight loss over the past 2 months. He has COPD and a 55-pack-year smoking history. His only medication is an albuterol inhaler. Temporal muscle wasting and proximal muscle wasting and weakness are noted in the upper and lower extremities on physical exam. Hyperpigmented mucous membranes are noted. Following laboratory studies and examination of the toenail beds, what is the most likely cause of this patient's findings?.
https://immattersacp.org/archives/2014/02/mksap.htm
1 Feb 2014
MKSAP Quiz: evaluation of chronic fatigue syndrome
A 32-year-old woman is evaluated following a diagnosis of chronic fatigue syndrome. She has a several-year history of chronic disabling fatigue, unrefreshing sleep, muscle and joint pain, and headache. Following a physical exam, what is the most appropriate management for this patient's symptoms?
https://immattersacp.org/weekly/archives/2014/02/11/3.htm
11 Feb 2014
MKSAP Quiz: 6-month history of dysphagia
A 50-year-old man is evaluated for a 6-month history of dysphagia. He describes a sensation of both solids and liquids sticking in the midesophageal area. This sensation has slowly worsened over time. He also describes intermittent midsternal discomfort that is nonexertional and is usually precipitated by swallowing food. He has lost 4.5 kg (10.0 lb). He has had no history of heartburn or acid regurgitation. Following a physical exam and barium swallow, what is the most appropriate management?.
https://immattersacp.org/archives/2014/03/mksap.htm
1 Mar 2014
MKSAP Quiz: 2-week history of nonproductive cough and fever
A 35-year-old man is evaluated for a 2-week history of nonproductive cough and fever. He has a 20-year history of asthma. Three weeks ago, he visited friends in Indiana. He has no dyspnea, hemoptysis, or worsening of his baseline asthma symptoms. His only medication is an albuterol inhaler as needed. Following a physical exam, lab results and a chest radiograph, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2014/03/04/3.htm
4 Mar 2014
MKSAP Quiz: routine follow-up visit for diabetes and hyperlipidemia
A 59-year-old woman is evaluated during a routine follow-up visit. She was recently diagnosed with type 2 diabetes mellitus and hyperlipidemia. She feels well. Medications are metformin, atorvastatin, and aspirin. Following a physical exam and lab results, what is the most appropriate diagnostic test to perform next?
https://immattersacp.org/weekly/archives/2014/03/11/3.htm
11 Mar 2014
MKSAP Quiz: 3-week history of painful muscle spasms and twisting movements
A 24-year-old woman is evaluated for a 3-week history of painful muscle spasms and twisting movements in the neck and trunk. She says that her neck feels as if it is being pulled backward. She also reports general restlessness and an inability to keep still. Her medical history is notable for asthma, type 1 diabetes mellitus, and gastroparesis with reflux. The patient has no family history of neuropsychiatric disorders or liver disease. Medications are albuterol, insulin, omeprazole, and metoclopramide. Following findings from a physical exam, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2014/03/18/3.htm
18 Mar 2014
MKSAP Quiz: increasing asthma symptoms
A 24-year-old woman is evaluated for increasing asthma symptoms. Her symptoms now require her to use her as-needed albuterol inhaler two to three times per week, and she has been waking up at night at least once a week with asthma symptoms that require her inhaler. She is still able to perform most of her daily activities, including regular exercise, if she uses albuterol for prevention. She is allergic to house dust mites, ragweed, grass, trees, and cats. Following a physical exam and spirometry, what is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2014/03/25/3.htm
25 Mar 2014
MKSAP Quiz: 3-month history of left knee pain
A 76-year-old woman is evaluated for a 3-month history of left knee pain of moderate intensity that worsens with ambulation. She reports minimal pain at rest and no nocturnal pain. There are no clicking or locking symptoms. She has tried naproxen and ibuprofen but developed dyspepsia; acetaminophen provides mild to moderate relief. The patient has hypertension, hypercholesterolemia, and chronic stable angina. Medications are lisinopril, metoprolol, simvastatin, low-dose aspirin, and nitroglycerin as needed. Following a physical exam, lab results and radiograph, what is the next best step in management?
https://immattersacp.org/weekly/archives/2014/04/01/3.htm
1 Apr 2014
MKSAP Quiz: ED evaluation for midsternal pain
A 59-year-old woman is evaluated in the emergency department for midsternal chest pain. The pain began several hours ago as a vague ache in her left upper sternal region that progressed in intensity and severity. The pain abated spontaneously after approximately 45 minutes. She had no further chest pain until several hours later, when it recurred unprovoked by exertion. She has no shortness of breath, nausea or vomiting, syncope, previous history of chest pain, or known cardiac disease or risk factors for venous thromboembolism. Medical history is significant for hyperlipidemia and hypertension. She does not smoke cigarettes. Medications are simvastatin, aspirin, lisinopril, and hydrochlorothiazide. Following a physical exam, electrocardiogram and chest radiograph, what is the most appropriate initial management?.
https://immattersacp.org/archives/2014/04/mksap.htm
1 Apr 2014
Refine your referrals to physical rehab with thought, timeliness
Internists can vastly improve outcomes for patients by referring more patients to physical rehabilitation earlier, more often, and for more conditions than they might think.
https://immattersacp.org/archives/2014/04/rehabilitation.htm
1 Apr 2014