Tim is a 4-year-old with low-grade temp and a painful left ear. Your physical examination is within normal limits but limited by cerumen obstruction of the ear canal, so you cannot assess his tympanic...
Samantha is a 35-year-old woman who has strayed well beyond the recommended interval for pap testing. She said that at her last examination 7 years ago, insertion of the speculum was so painful that she was...
John is a 32-year-old homeless man who had recently been admitted for upper gastrointestinal bleeding. He was diagnosed with gastritis, related to a combination of risk factors including excessive alcohol....
Adam is a high school student who uses a fluticasone nasal spray 3 months of each year for seasonal allergic rhinitis. Although his symptoms are well controlled, he gets nosebleeds 2-3 times each allergy...
Alfredo is a 37-year-old who comes to the emergency department complaining of renal colic. Note: Alfredo is a “frequent flyer” in the emergency department and many staff members know him by name.
Heckel noted that when he went away for a weekend to visit his mother and forgot to take his statin, the myalgias went away. When he returned home and restarted the statin, myalgias returned.
Mary is a 34-year-old G2P2 woman with idiopathic menorrhagia. For the past 15 years, she has experienced prolonged menses (≥ 8 days) requiring 7 to 10 pads/d.
Marvin is a 32-year-old man who has been married for 3 years and is planning to start a family. He has experienced premature ejaculation since adolescence and although his partner is willing to “put up with...
