a = 5.5m, b = 1.0m, and

You have been the PCP for a 72-year-old female for the past 3 years.  Her 2 daughters brought her to clinic today.  She currently lives in her own home alone and her daughters live nearby.  Her daughters are concerned about her because she has been more forgetful and recently had trouble driving home from church.  She got lost and had to stop and ask how to get to her address.  They have noticed these changes over the past year or so, but more often lately.  She denies headaches, chest pain, and palpitations. lightheadedness, SOB or loss of consciousness.  She states that she has been eating well, sleeping well, she enjoys a glass of wine with friends every other week or so. Her husband of 46 years died 4 years ago.  She has stayed active in her community and in her church.  She has generally been in good health and has regular health care, follow up.  She misses her husband but has generally been in good spirits.  PMH:  Stable hypothyroid – diagnosed 8 years ago Complete PE:  results within normal limits Medications:  Levothyroxine 50 mcg daily, no other medications, herbs or supplements Labs (2 days ago):  CBC, CMP, TSH, vitamin B12, folate:  normal.  Lipids, mildly elevated (you and MA have chosen not to treat with medication) EKG:  NSR, no ectopy You are concerned about the potential for early dementia. You review the chart, talk to the patient and family, and consider the following in your diagnosis:

Your next patient is a 62-year-old male who has been a patient in your clinic for more than 10 years.  He does not come to the clinic often. He was informed from the triage RN that he needs to be seen by his health care provider to get his cholesterol and blood pressure prescriptions renewed.  He doesn’t understand why he can’t just get these filled without an appointment.  He was last seen in the clinic 18 months ago and states that he feels fine. He was informed at that clinic visit that he had pre-diabetes with a hemoglobin A1C of 6.0% (normal below 5.7%).  At that time he wanted to try to modify his diet and start an exercise routine before starting another medication.   His treatment plan included him checking his BP at home daily and recording.  He admits that he took his BP regularly for a while, but he became very busy at his stressful job and hasn’t checked it lately.   You want him to understand the importance of follow up, so you tell him the following:

For which of the following congenital cardiac defects are considered ductal dependent, and closure of the ductus arteriosus could have catastrophic consequences for the patient?I. Tetralogy of Fallot with pulmonary atresiaII. Atrial septal defectIII. Severe coarctation of the aortaIV. Hypoplastic left heart syndrome

Which neurotransmitter is hypothesized to be the “final common pathway” of rewarding drug effects?

A 28-year-old female patient comes to clinic for a routine physical exam. While gathering her medical history, she reports a previous diagnosis of infectious mononucleosis in her late teens and mentions she has had a vitamin D deficiency because of where she lives. She is also concerned about a family history of autoimmune diseases. Considering the most recent evidence on risk factors for multiple sclerosis (MS), which of the following factors would most likely contribute to her risk of developing MS?

Which of the following is/are blood borne disease(s) associated with injection drug use?

The two main classifications of stroke are ischemic and hemorrhagic. Which of the following is NOT a common modifiable risk factor for ischemic stroke?

Which statement is NOT true concerning neurotransmitters?

What is the main type of crime committed by opiate users?