M.R. is a 28-year-old female patient in good health that visits the clinic for the first time. She recently moved to Florida from New York due to work relocation. She admits not visiting her PCP frequently but requires medical clearance for her new clerical position. She is sexually active, unprotected, in a monogamous relationship. ROS and physical examination are unremarkable. What to do?
A) Is there a form to fill? yes or not. If yes, what are the requirements?
B) Laboratory work-up:
Routine: CBC w/ differential; CMP; U/A ØTitters?
C) Is a 12-Lead EKG required?
D) Is a CXR necessary?
E) Would you do HCG?
F) What about other recommendations for screening? Which type of level of care is this?
2- A 58-year-old male patient with history of HTN and T2DM presents to the clinic for a regular check up. He denies current symptomatology and his last check up was 2 years ago. In addition to a thorough physical examination. Which laboratory test would expect to be ordered? (Select all that apply)
A)CBC, BMP, U/A
B)CBC, CMP, U/A
C)Lipid profile
D) Cardiac enzymes
E)HgbA1c
F)TSH
G) CXR
3) The patient’s anti-HTN treatment includes Lisinopril 10 mg PO daily and Amlodipine 5 mg PO daily. Are there any findings physical or laboratory expected from this medications?
4) You would look at the levels of Magnesium and Phosphorus for the replacement of Potassium if applicable. Which of the following tests would include these two electrolytes?
a) BMP
b)CMP
c)Liver profile
d)Lipid profile
M.R. is a 28-year-old female patient in good health that visits the clinic for the first time
**M.R., 28-year-old Female Patient:**
A) Yes, there likely is a form to fill for medical clearance. The requirements typically include a comprehensive medical history, physical examination, and possibly laboratory tests to ensure the patient’s fitness for the clerical position.
B) Laboratory work-up:
– Routine: CBC with differential to assess for any blood cell abnormalities, CMP (Comprehensive Metabolic Panel) to evaluate electrolyte balance and organ function, and U/A (Urinalysis) to screen for urinary tract infections or other abnormalities. Titters are not typically necessary unless indicated by specific risk factors or symptoms.
C) A 12-Lead EKG may not be required for a routine medical clearance unless there are specific cardiovascular risk factors or symptoms present.
D) A CXR (Chest X-ray) is not typically necessary unless indicated by specific risk factors or symptoms.
E) HCG (Human Chorionic Gonadotropin) may be considered if there is a possibility of pregnancy, especially since the patient is sexually active, although she states she is in a monogamous relationship.
F) Other recommendations for screening may include cervical cancer screening (Pap smear) and sexually transmitted infection (STI) testing based on the patient’s sexual history. This level of care is considered primary care.
**58-year-old Male Patient with HTN and T2DM:**
A) CBC, CMP, U/A are commonly ordered for a regular check-up to assess for any abnormalities in blood counts, electrolytes, and kidney function.
C) Lipid profile is essential for assessing cardiovascular risk, especially given the patient’s history of hypertension and diabetes.
E) HgbA1c (Glycated Hemoglobin) is crucial for monitoring long-term glucose control in patients with diabetes.
F) TSH (Thyroid-Stimulating Hormone) may be ordered to assess thyroid function, as thyroid disorders are common comorbidities in patients with diabetes.
3) Anti-HTN treatment with Lisinopril and Amlodipine may lead to findings such as decreased blood pressure and potential electrolyte imbalances (e.g., hyperkalemia with Lisinopril, hypokalemia with Amlodipine). Regular monitoring of blood pressure and electrolyte levels is essential to ensure medication effectiveness and safety.
4) The test that would include Magnesium and Phosphorus among other electrolytes is option B) CMP (Comprehensive Metabolic Panel). This panel typically includes electrolytes, glucose, kidney function tests, and liver function tests, providing a comprehensive assessment of metabolic status.
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