A twenty-seven-year-old man of Mediterranean ancestry develops dark urine and jaundice two days after starting a sulfonamide antibiotic. His father has a known red blood cell enzyme deficiency. What is the most appropriate first management step?

A fifty-nine-year-old woman has had diabetes mellitus type 2 for 15 years. She takes metformin and a sodium glucose cotransporter two inhibitor. Her glycosylated hemoglobin is 7.3. Blood pressure is 142/86 millimeters of mercury. Recent laboratory tests show a urine albumin–to–creatinine ratio that is mildly elevated on two separate occasions and a normal estimated glomerular filtration rate. She has no known cardiovascular disease. Which change in her treatment plan is most consistent with current outpatient guidelines to protect kidney function? 

An eighty-one-year-old man presents for follow-up after three falls in the past two months. He lives alone, uses a cane outside the home, and denies loss of consciousness with the falls. He reports feeling “lightheaded” when he stands up quickly. His medications include a long-acting beta blocker, an angiotensin-converting enzyme (ACE) inhibitor, and a thiazide diuretic for hypertension, plus a daily multivitamin. Supine blood pressure: 112/62 millimeters of mercury; pulse 60. Standing blood pressure (one minute): 92/56 millimeters of mercury; pulse 62. Neurologic examination is nonfocal, and his gait is slow but not clearly ataxic. Which management step is the most appropriate first action in primary care to reduce his future fall risk?

A twenty-seven-year-old man of Mediterranean ancestry develops dark urine and jaundice two days after starting a sulfonamide antibiotic. His father has a known red blood cell enzyme deficiency. What is the most appropriate first management step?

A forty-two-year-old woman is being treated for iron deficiency anemia (IDA) related to heavy menstrual bleeding. She is taking an oral iron supplement as prescribed and asks what she can do with her diet to help her blood count improve. Which advice best reflects evidence-based nutritional teaching for iron deficiency anemia (IDA)?

An eighty-one-year-old man presents for follow-up after three falls in the past two months. He lives alone, uses a cane outside the home, and denies loss of consciousness with the falls. He reports feeling “lightheaded” when he stands up quickly. His medications include a long-acting beta blocker, an angiotensin-converting enzyme (ACE) inhibitor, and a thiazide diuretic for hypertension, plus a daily multivitamin. Supine blood pressure: 112/62 millimeters of mercury; pulse 60. Standing blood pressure (one minute): 92/56 millimeters of mercury; pulse 62. Neurologic examination is nonfocal, and his gait is slow but not clearly ataxic. Which management step is the most appropriate first action in primary care to reduce his future fall risk?

A seventy-nine-year-old woman presents for an older adult annual visit. She lives alone and reports one fall in the past three months when turning quickly in her kitchen. She walks without a device at home but holds on to furniture. You perform a Timed Up and Go test: she needs 17 seconds to stand from a chair, walk 10 feet, turn, return to the chair, and sit. She needs to use her hands to push off and feels slightly unsteady when turning. Which management step is the most appropriate next action in primary care to reduce her future fall risk?

A seventy-nine-year-old woman with known dementia becomes acutely more confused and agitated over two days. Her daughter asks whether she should wait for the next routine clinic appointment. What should you advise?

An eighty-three-year-old woman fell at home last week without loss of consciousness. Today she reports mild hip pain when walking. Hip radiographs are normal, and she has no weakness or neurologic deficits. What is the most appropriate plan in primary care?

A fifty-six-year-old woman is evaluated for anemia during a primary care visit. Her complete blood count (CBC) confirms low hemoglobin. Reticulocyte count is low. What does the low reticulocyte count primarily suggest about the cause of her anemia?