![]() Three days after hospitalization for diabetic ketoacidosis, an 87-year-old woman refuses insulin injections. (E) Soy protein shakes throughout pregnancy and lactation (D) Iron supplementation during the first trimester (C) Calcium supplementation during the first trimester (B) Beginning folic acid supplementation prior to conception (A) Adjusting diet to include more sources of protein during the first trimester Which of the following is most likely to decrease the risk of fetal anomalies in this patient? Pelvic examination shows a normal appearing vagina, cervix, uterus, and adnexa. Physical examination shows no abnormalities. ![]() She is 157 cm (5 ft 2 in) tall and weighs 50 kg (110 lb) BMI is 20 kg/m 2. Menses occur at regular 28-day intervals and last 5 days. She does not eat meat, fish, or dairy products and wishes to decrease the risks of her diet on her baby. She is recently married and would like to conceive within the next year. Which of the following is the most likely diagnosis?Ī 21-year-old woman comes to the office for counseling prior to conception. Laboratory studies show: HematocritĪn x-ray of the left knee shows calcification of the synovium. He holds the knee in 30 degrees of flexion the pain is exacerbated with further flexion or extension. The knee is hot to touch and erythematous. Examination of the knee shows a large effusion. Current medications include aspirin, metoprolol, lisinopril, simvastatin, clopidogrel, and heparin. Cardiac catheterization showed occlusion of the left anterior descending artery, and he underwent placement of a stent. He was admitted to the hospital 2 days ago for an acute myocardial infarction. Serum studies are most likely to show which of the following sets of findings in this patient?Ī hospitalized 57-year-old man has had severe progressive pain in his left knee since awakening 2 hours ago. Physical examination shows dry mucous membranes, erosion of enamel on the lingual surface of the front teeth, and hypertrophy of the parotid gland. She is 165 cm (5 ft 5 in) tall and weighs 57 kg (125 lb) BMI is 21 kg/m 2. She has no history of serious illness and takes no medications. She reports a loss of control during these episodes, saying, "It's like I stop thinking at all and before I know it, I have eaten two pizzas." She induces vomiting several times during each binge and has developed a pattern of binging and purging every evening. She states that she has tried to diet to improve her appearance but that food restriction often "backfires" because she becomes hungry and then engages in episodes of binge eating. She reports that she feels well but is nervous about leaving home for the first time. ![]() A 17-year-old girl comes to the office for an examination prior to entering college.
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