66-year-old man with hormone-refractory prostate cancer comes into your office for
a follow-up visit. You suggest he consider participating in a clinical trial, which is
designed to compare 2 different chemotherapy regimens in men with his disease. The
trial is being conducted at cancer centers throughout the country, and will enroll
about 400 patients. What is the most likely phase trial of this drug?
Give this one a try later!
Phase III trial
A father has brought his daughter in for a wellness visit. He tells you that she is a good
child who likes to ride her tricycle and play with her cousins. The little girl smiles when
you smile at her, and she tells you her name is Brenda. She also tells you how old she
is. As you talk to her further, you notice she uses plural nouns and past tense verbs in
3 word sentences. She exhibits the normal developmental milestones of a child at
what age?
,Give this one a try later!
3-year-old
You are performing an annual physical examination on a 14-year-old girl. In the last
couple of years, she started having constipation "every other day or so," followed by
loose stools. She still feels depressed because of her parents' recent divorce. She has
no problems at school, her grades are good, and she participates in sports. Her
mother is worried because she is so slim despite excellent appetite: that she has not
grown enough. She still has not gotten her period. Her mother had her first period
when she was 13. The rest of personal and family history is non-contributory. The
patient's height is 5 ft, weight 79 lb (BMI 15.46; 3rd percentile); she is in Tanner stage 2
(the same as last year, according to her records); and her bone age is 12.5 years. The
rest of physical examination is normal. Laboratory shows Hct of 31% and MCV of 73,
low insulin-like growth factor (IGF), low FSH, positive anti-tissue transglutaminase
antibodies. The rest of laboratory results are within normal limits, including TSH and
prolactin. What will restore normal puberty, growth, and weight in your patient?
Give this one a try later!
Gluten-free diet
A 10-year-old girl presents for a school physical. Her mother is concerned because
this patient has pubic hair, which her mother thinks is premature. On physical
examination, she has enlarged areola and a small amount of breast tissue. She also
has sparse, dark, but mostly straight pubic hair. Based on the Tanner scale of sexual
development, in what stage of pubescence is this young girl?
Give this one a try later!
, Tanner II
A mother brings her child in for a well baby check-up. He is 9 months old, crawls,
pulls to stand, uses 3-finger pincer grasp, says mama/dada, waves bye-bye, and plays
Pat-a-cake. The mom is concerned and wishes to know the status of her child's
development. What is the status of the infant's development?
Give this one a try later!
Normal motor, social, and language
55-year-old African-American woman has a 2-day history of Stage 4 chronic kidney
disease and traumatic lower leg amputation; she presents with right epigastric pain
and a low-grade fever. Her temperature is 37.3° C, pulse is 88/min, respirations are
14/min, and BP is 120/82 mm Hg. On examination, the abdomen is soft, with right
upper quadrant tenderness and a positive Murphy's sign. An ultrasonogram is
consistent with clinical diagnosis of cholecystitis. She has no known cardiac history or
symptoms. She is currently not on any medications, and she is allergic to penicillin.
Her surgeon would like to perform an open cholecystectomy. As her physician, how
should you best approach her preoperative evaluation?
Give this one a try later!
Assess her surgery-specific risks, functional capacity, and medical
predictors of cardiac risk
51-year-old man with metastatic colon cancer comes into your office for a follow-up
visit. He has been treated with chemotherapy, but his last CT scan showed he still had
several large metastases in his liver; treatment was stopped. He tells you about a
a follow-up visit. You suggest he consider participating in a clinical trial, which is
designed to compare 2 different chemotherapy regimens in men with his disease. The
trial is being conducted at cancer centers throughout the country, and will enroll
about 400 patients. What is the most likely phase trial of this drug?
Give this one a try later!
Phase III trial
A father has brought his daughter in for a wellness visit. He tells you that she is a good
child who likes to ride her tricycle and play with her cousins. The little girl smiles when
you smile at her, and she tells you her name is Brenda. She also tells you how old she
is. As you talk to her further, you notice she uses plural nouns and past tense verbs in
3 word sentences. She exhibits the normal developmental milestones of a child at
what age?
,Give this one a try later!
3-year-old
You are performing an annual physical examination on a 14-year-old girl. In the last
couple of years, she started having constipation "every other day or so," followed by
loose stools. She still feels depressed because of her parents' recent divorce. She has
no problems at school, her grades are good, and she participates in sports. Her
mother is worried because she is so slim despite excellent appetite: that she has not
grown enough. She still has not gotten her period. Her mother had her first period
when she was 13. The rest of personal and family history is non-contributory. The
patient's height is 5 ft, weight 79 lb (BMI 15.46; 3rd percentile); she is in Tanner stage 2
(the same as last year, according to her records); and her bone age is 12.5 years. The
rest of physical examination is normal. Laboratory shows Hct of 31% and MCV of 73,
low insulin-like growth factor (IGF), low FSH, positive anti-tissue transglutaminase
antibodies. The rest of laboratory results are within normal limits, including TSH and
prolactin. What will restore normal puberty, growth, and weight in your patient?
Give this one a try later!
Gluten-free diet
A 10-year-old girl presents for a school physical. Her mother is concerned because
this patient has pubic hair, which her mother thinks is premature. On physical
examination, she has enlarged areola and a small amount of breast tissue. She also
has sparse, dark, but mostly straight pubic hair. Based on the Tanner scale of sexual
development, in what stage of pubescence is this young girl?
Give this one a try later!
, Tanner II
A mother brings her child in for a well baby check-up. He is 9 months old, crawls,
pulls to stand, uses 3-finger pincer grasp, says mama/dada, waves bye-bye, and plays
Pat-a-cake. The mom is concerned and wishes to know the status of her child's
development. What is the status of the infant's development?
Give this one a try later!
Normal motor, social, and language
55-year-old African-American woman has a 2-day history of Stage 4 chronic kidney
disease and traumatic lower leg amputation; she presents with right epigastric pain
and a low-grade fever. Her temperature is 37.3° C, pulse is 88/min, respirations are
14/min, and BP is 120/82 mm Hg. On examination, the abdomen is soft, with right
upper quadrant tenderness and a positive Murphy's sign. An ultrasonogram is
consistent with clinical diagnosis of cholecystitis. She has no known cardiac history or
symptoms. She is currently not on any medications, and she is allergic to penicillin.
Her surgeon would like to perform an open cholecystectomy. As her physician, how
should you best approach her preoperative evaluation?
Give this one a try later!
Assess her surgery-specific risks, functional capacity, and medical
predictors of cardiac risk
51-year-old man with metastatic colon cancer comes into your office for a follow-up
visit. He has been treated with chemotherapy, but his last CT scan showed he still had
several large metastases in his liver; treatment was stopped. He tells you about a
