A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her daughter and looks to her daughter to answer questions during the interview. She was diagnosed with early Alzheimer’s disease 2 years ago, and her daughter would like her current mental status evaluated. You ask the patient her daughter’s name, and she answers correctly. You ask her the date and time, and she answers incorrectly. Her daughter says that her mom seems frustrated and confused because she can’t seem to speak as well or understand things the way she used to. Her daughter says that this morning, for example, her mom was trying to say “put the car in the garage” and it came out as “put the train in the house.” You hand the patient a pencil and ask her if she knows what it is. She replies with, “Is it a stick?” You ask the patient to put on a patient gown, and she does not know how to perform the task. These are examples of disorientation to time and:

A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her daughter and looks to her daughter to answer questions during the interview. She was diagnosed with early Alzheimer’s disease 2 years ago, and her daughter would like her current mental status evaluated. You ask the patient her daughter’s name, and she answers correctly. You ask her the date and time, and she answers incorrectly. Her daughter says that her mom seems frustrated and confused because she can’t seem to speak as well or understand things the way she used to. Her daughter says that this morning, for example, her mom was trying to say “put the car in the garage” and it came out as “put the train in the house.” You hand the patient a pencil and ask her if she knows what it is. She replies with, “Is it a stick?” You ask the patient to put on a patient gown, and she does not know how to perform the task. These are examples of disorientation to time and:

A 26-year-old male patient came to your clinic today complaining from severe burning sensation during urination and dysuria for 4 days. He states he has been suffering from penile discharge and testicular tenderness. He has a history of multiple heterosexual relationships with a last contact 2 days ago. On physical examination, vital signs show: blood pressure 110/79, pulse 75, and temperature 37.6°C. There is mucopurulent cloudy discharge from urethra (see photo). There are soft, fleshy, raised lesions on the glans and prepuce. You obtain a positive culture and gram stain of discharge shows gram negative diplococci and WBCs. Based on the most likely differential diagnosis, what is the most likely differential diagnosis and should this condition be reported to the Health Department per the CDC guidelines?

A 26-year-old male patient came to your clinic today complaining from severe burning sensation during urination and dysuria for 4 days. He states he has been suffering from penile discharge and testicular tenderness. He has a history of multiple heterosexual relationships with a last contact 2 days ago. On physical examination, vital signs show: blood pressure 110/79, pulse 75, and temperature 37.6°C. There is mucopurulent cloudy discharge from urethra (see photo). There are soft, fleshy, raised lesions on the glans and prepuce. You obtain a positive culture and gram stain of discharge shows gram negative diplococci and WBCs. Based on the most likely differential diagnosis, what is the most likely differential diagnosis and should this condition be reported to the Health Department per the CDC guidelines?

A 47-year-old female presents to your primary care clinic today for a well-check exam and inquires about the need for a mammogram. She has no family history of breast or ovarian cancer. She gave birth to her only child at 25 years of age and she breastfed for 8 months. She does not smoke and she drinks “socially” less than 1 drink per week. Her last mammogram was 24 months ago and was “normal.”  Which of the following should you advise this patient.

Case Study: A 33-year-old male fell from a ladder while painting a house. Upon arrival at the emergency department, he was conscious but disoriented and complained of a severe headache. Examination revealed a small cut on his scalp, but no other visible injuries. He experienced confusion and had difficulty answering questions. A CT scan showed a thin, linear fracture on the right parietal bone without depression or displacement. Based on the patient’s symptoms and CT scan results, what is the most likely type of skull fracture?  

A person who gets hit on the back of the head might suffer injury to which of these bones?  

Identify the fracture type:

Identify the fracture type:  

Identify the fracture type: