A 52-year black male presents for a routine health screen. Recently, he has been making attempts to lose weight and eat healthier, but has noticed his blood pressure being elevated at the gym. Your records show that he was seen two weeks ago at your affiliated urgent care site and had a blood pressure reading of 144/88. Today in the office you measure a blood pressure of 150/100. His physical exam findings are unremarkable, he has no additional complaints, and he takes no medications. Recent blood work is also negative for any evidence of diabetes or kidney disease. Which of the following is the next best step in management?

The activation of the sympathetic nervous system after a major burn results in:

An 84 year-old male nursing home resident presents to the ER with fever and altered mental status. EMS reports he was last seen as “normal” by nursing home staff approximately 5 hours ago. His vitals reveal a heart rate of 120, respiratory rate of 18, BP of 82/50, MAP 54 and temperature of 102.2°F exhibiting altered mental status. Physical exam reveals an ill-appearing man with localized expiratory wheezing heard over the left lower lobe, and chest x-ray confirms a localized area of consolidation with increased interstitial markings in the left lower lobe. Lab results are significant for a white blood cell count of 24,000. Based on this patient’s presentation, he can best be diagnosed with which of the following?

Undiagnosed pneumonias can lead to:

A 79 year-old male with history of hypertension, benign prostatic hypertrophy, and normal renal function presents to the emergency department with symptoms of fever and generalized weakness that has been ongoing for the past two days. His family notes that he has not been eating as much today and fell when trying to stand up from his chair. He also seems sleepier than usual today. On review of symptoms, the patient denied any symptoms other than stating “I just don’t feel well”. Pertinent physical exam findings include the following: ill appearing diaphoretic elderly gentleman, tachycardia, tachypnea, slight discomfort to palpation of suprapubic region, and mottling of the skin of his extremities. His vitals are as follows: Heart rate: 135 beats/minute, Respiratory rate: 25 breaths/minute, Blood pressure: 72/45 mm Hg, pOx: 91% on room air, and temperature of 38.5C. Labs are sent and chest X-ray is done with the following results:  WBC 24.1 Normal: 4.0-10.5 x103/uL Hb 10.2 Normal: 14-16 g/dL HCT 31% Normal: 42-48% PLT 490 Normal: 150-450 x 103/uL Bands.      12% Normal: 0-5 Sodium     144  Normal: 135 – 145 mmol/L  Potassium 3.1 Normal: 3.5-5.0 mmol/L Chloride 106 Normal: 96-106 mmol/L CO2 18 Normal: 23-29 mmol/L BUN 44 Normal: 6-20 mg/dL Creatinine 2.1 Normal: 0.8-1.2 mg/dL Glucose 61 Normal: 64-100 mg/dL eGFR 49 Normal: >60 mL/min Lactate 4.5 Normal: 0-2.0 mmol/L Urinalysis shows >30 wbcs, 4+ bacteria, and positive nitrates. Portable chest xray shows slight blunting of costophrenic angles with no evidence of infiltrates or consolidations. At what point would it be appropriate to initiate pressor support with norepinephrine for this patient?

Secondary hypertension is rapidly progressive hypertension in which diastolic pressure is usually greater than 140 mmHg. 

Look at the figure 1. If the economy is in equilibrium at Y1, it is in:  quiz 5- Figure 1.png

The aggregate demand curve is downward sloping because of 

A child has chronic hepatitis, and the healthcare professional wants to assess the child for portal hypertension. What action by the professional is most appropriate?

A 2-week-old who has previously nursed well has now begun vomiting immediately after feeding. Which condition presents with this behavior?