FEP.jpg A 50-year-old female patient presents to your practice with a complaint of a growth on the inside of her left cheek. She noticed this growth for more than 5 years. It started out small but lately she realized that it is slowly increasing in size. When asked about a history of trauma she did not report anything significant. The growth does not cause her any pain, but when she accidentally bites the lesion, it ulcerates leading to mild pain. She does not have any medical illnesses; is not allergic to any medications and does not chew betel quid, smoke cigarettes, or drink alcohol. The slide above shows a lesion with overlying normal mucosa with a smooth surface and a focal keratotic surface (indicated by the arrow).   Based on the information above, formulate a differential diagnoses from the list below (1 being most likely to 4 being least likely).

A 6 month old girl presents with muscle spams involving the limbs, with flexor spasms predominating over the extensor spasms. Her electroencephalogram shows hypsarrhythmia. What is most likely to be associated with this presentation?

A 7 year old boy presents with urticaria and swollen lips after eating desert at a school function. Further examination reveals a tachycardia, warm extremities, a capillary refill of 4 seconds, and decreased mentation on neurological examination. What is the circulatory assessment of this child?

A mother brings her 18 month old son for vaccination. Her son is underdressed for the cold winter day. What will make you suspect child abuse in the form of neglect for this child?

The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is class:

Wilma is an 80 year old with urinary incontinence. You prescribe oxybutynin chloride. When teaching Wilma about this medication,  you should tell her:

The American Heart Association and the American College of Cardiology have devised a classification system for heart failure that can be used to direct treatment. Patients with symptoms and underlying disease are classified as stage:

Angina is produced by an imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS?

The most common cause of coronary artery disease is:

What is the benefit of using a SERM (selective estrogen receptor modulator) for a 60-year-old female who doesn’t want to take any estrogen products?