Anita is a 37-year-old who presents as a new admission physi…

Anita is a 37-year-old who presents as a new admission physical from a local assisted living facility that cares for a lot of mentally ill adults. She has told the staff and yourself that she has been taking alprazolam 1 mg at least QID for the last several months (she obtained illicitly).  The staff would like to discontinue this medication.  What’s your best plan?

Kaitlyn is a 20-year-old college student who presents for ev…

Kaitlyn is a 20-year-old college student who presents for evaluation of inability to quit crying.  She is accompanied by her Mom who has driven to campus to pick her up and take her home due to her concerns. Kaitlyn tells you that two weeks ago her professor in her film class had the group watch a film that “was really really scary”.   She states she is sleeping well, feels rested when she gets up, is still going to class and has been able to concentrate on her studies, “the only thing I can’t seem to do is quit crying and I haven’t been able to write my review paper for the film we watched”.  She wakes up crying each morning and will start to cry for no reason during class, “I don’t feel sad”.  You note that Kaitlyn appears Asian and her mother appears Caucasian. As part of the history, you find that she was raised in an orphanage in China until the age of 5, when she was adopted by her.  She has a very difficult time in recounting this history.  What is your working diagnosis? 

Frances is a 92-year-old woman you see at the nursing home. …

Frances is a 92-year-old woman you see at the nursing home.  She has multiple co-morbidities including diabetes, CAD, congestive heart failure, COPD, and  hyperlipidemia,  She was recently hospitalized with pneumonia, and in part of the work up a chest CT was performed that captured, the upper part of her abdomen and showed a large gallstone in her gallbladder.  She is asymptomatic for cholecystitis or dysfunction, but she and her family are concerned that this will create a problem if it is left untreated.  The surgeon has expressed concern about her ability to survive a surgery to remove the gallbladder.  What would you advise?