An 18 yr old male comes to the ER with c/o sudden onset of SOB and chest pain. He denies injury, illness or cough. Percussion hyperresonant, fremitus absent, breath sounds NOT audible over Right chest, RR 32. The Left chest is normal. The most likely diagnosis is:

Lennie, a 15 year old athlete is in for a follow-up exam. He recently injured his right leg playing football. He is able to raise his right leg off of the exam table, as long as there is no resistance applied. How would your grade the strength of his right leg?

First degree heart block is evident on an EKG by:

Three years later the patient presents to the community pharmacy to purchase loperamide 2mg capsules. They report a 48-hour history of persistent diarrhoea and vomiting following a meal at a restaurant.   Their repeat medications are recorded below: Apidra (Insulin glulisine) 100 units/mL pre-filled Solostar pens, 1 unit per 10 gram carbohydrate Tresiba (Insulin Degludec) 100 units/mL pre-filled pens, 12 units once a day Rigevidon (ethinylestradiol, levonorgestrel) take one tablet daily for 9 weeks followed by a 4-day pill free period. Sertraline 100mg tablets, take one daily

An S3 heart sound is heard:

What is the most appropriate action to take in relation to their insulin regimen?

Identify the skin lesions below.        

Possible causes of a pathologic SYSTOLIC murmur include:

END OF EXAM

Which factor does NOT influence the development of osteoporosis: