Identify the author: The first American poet to achieve general recognition and to appreciate nature for its own sake. Mostly a moralist using nature to teach philosophical lessons. He idealized nature. He was acquainted with the major Hudson River School of Painting artists, especially Thomas Cole.

Elisabet is a 23-year-old who presents requesting your help,  “You’re the only one I can trust”.  She says that she is pregnant and the next Virgin Mary but relates that “they’re out to get me so I’ll abort this baby”.  “They have even made me start my period, but it’s all a trick, I KNOW I’m pregnant”.  She tells you that she is being followed, but managed to get away from her pursuers with an elaborate scheme to evade them.  “I know you’ll protect me”.  About now, you decide you should have called in sick for clinic and that you’re either in the midst of a James Patterson novel or perhaps a horrible dream.  When you open your eyes and see Elisabet is still there, you begin to whittle down to a list of differential diagnosis.  What do you think is going on?  Remember….I don’t make these things up!! They’re based on things I’ve actually had happen in the office :).  Please select all that apply.

You suspect your 22 year-old patient has panic disorder.  What is the most appropriate work up to complete to establish this diagnosis? 

You confirm your patient has IBS-D.  According to the American College of Gastroenterology, what do you include in your treatment plan?  Select all that apply. 

Eric is planning a trip this next summer to meet his friends and family in Ghana.  He presents to clinic requesting your assistance with obtaining any required immunizations.  As you review the materials regarding Ghana, you see that the yellow fever vaccine is required.  What is the best way for you to proceed?

Liam is a 21-year-old who presents to the office because he can’t seem to quit crying.  When asked if he has any thoughts of harming himself he responds “I’d have to quit crying long enough to figure out how I’d do it”.  What is the most appropriate plan of care for this patient? 

What would be an appropriate motivational interviewing technique to utilize with a patient having substance abuse issues?

Marta  is a 35-year-old that you recently saw in the office with a major depression.  You started her on escitalopram (Lexapro) 20 mg daily.  Your nurse tells you that she has called and says she ” LOVES” this medicine!!!!  She relates her energy has improved significantly and she just wanted to let you know how well she is doing on it.  She related that she has been able to write three papers she needed to complete to submit for publication, baked a dozen homemade pies for a fundraiser, and opened a new bakery business in addition to her full time job of practicing law.  She is thrilled that the bank approved her loan to purchase a building to set up her bakery in. Given this information what do you suspect? 

A 28-year-old woman presents with a two month history of fatigue, sleeping much more than usual but still being fatigued when she awakens.  She tells you she could care less about her work and only shows up “because I have to pay the bills”.  She finds it hard to be at work as she is unable to make even the most straightforward of decisions.  She also has no desire to go out with her husband and expresses feeling very guilty as she doesn’t even want to have sex.  She tells you that she has no specific plan of harming herself, but feels as if her family would be “better off without me”.   According to the American College of Physicians (ACP) Nonpharmacologic and Pharmacologic Treatments of Adults in the Acute Phase of Major Depressive Disorder, what treatment options should be considered?  Please select all that apply.

Fran is a 47-year-old in your practice that you see annually for her women’s health exam as well as diabetes, hypertension, and hyperlipidemia.   She is a 1 ppd smoker x 20 years and has a number of medication intolerance’s. You are a bit concerned to hear she is preparing for an extended trip to the Amazon River Basin to perform research on a plant species she has been studying for the past 7 years (she has a PhD in agriculture sciences).  She will be camping at a remote research site.  She is quite concerned regarding travelers diarrhea. What would you advise her? Please select all responses that apply.