A 35-year-old woman presents with polycystic ovarian syndrome (PCOS). She wants to start trying to conceive soon. She currently has regular menstrual cycles since discontinuing birth control pills and 15 pounds of weight loss over the past few months. Her current list of medications includes a multivitamin with folic acid, albuterol (Ventolin), clindamycin topical lotion, […]

J.P. is a 37-year-old office manager who presents to her nurse practitioner with a complaint of arthritis in her wrists and ankles. She has gained 20 pounds in the past 6 months, despite eating a balanced diet. Her exercise regimen has suffered due to muscle cramps and headaches. On examination, the nurse practitioner palpates pitting […]

T.S. is a 17-year-old high schooler who presents to her family doctor with concern about excess body hair that has developed in the past year (especially embarrassing are some hairs growing along the jawline). She plays varsity volleyball, which accounts for her solid muscular build, but she is concerned that she has missed two periods […]

J.K. is a 52-year-old state auditor who presents to his personal physician with a chief complaint of muscle weakness and dizziness. He has lost 15 pounds in the past 5 months despite a regular appetite and exercise regimen (diminished due to the weakness). On examination, the doctor notices benign freckles formed around the lips and […]

A 12-year-old girl is evaluated for a painless rash, which first developed a day earlier. She has no fevers, chills, otalgia, or rhinorrhea. Her medical and family history are unremarkable. She recently returned from visiting her grandparents in a rural New England town. Physical examination is notable for a rash, as shown in the image […]