N6521 N: Mary is a 35-year-old woman that has been diagnosed with hypothyroidism. Her labs today show a TSH of 20, MCV 78, MCHD 26, Ferritin 9, TIBC 418. She has a history of iron deficiency anemia for 2 months. Current medications include Kelp tablets daily, ibuprofen 400 mg daily as needed, and ethinyl estradiol/norgestrel […]

A 26-year-old woman presents with suicidal ideation. She exhibits a depressed mood and has had a lack of pleasure in activities, insomnia, guilt, weight loss, and poor concentration. She has attempted suicide in the past and continues to consider self-harm. Three months ago, she had an episode of increased energy, grandiosity, promiscuity, flight of ideas, […]

A 22-year-old woman presents in clinic to follow up on a recent diagnosis of generalized anxiety disorder. She started taking sertraline 25 mg per day for a week and then titrated up to 50 mg per day for the next five weeks. She hasn’t noticed any symptom improvement. Which of the following is the best […]

A 22-year-old man with a history of schizophrenia has been admitted to the psychiatric department. He had been in remission for 2 years but has been having auditory hallucinations of hearing voices for the past 6 months. He does not seem to understand the questions that he is being asked and appears anxious. He has […]

A 35-year old female presents to the clinic with fever, dysuria, and frequent urination; she is prescribed antibiotics. Two weeks later, the patient presents to the ER with complaints of worsening symptoms. Patient states that they never picked up the originally prescribed antibiotic. Patient has a fever and elevated WBC count. Urinalysis is positive for […]

A 25-year-old woman presents to the emergency department with complaints of abdominal pain, vomiting, and diarrhea that has been present for five years. She states that no one has been able to help her up to this point. She reports numerous allergies to a variety of medications. Physical exam reveals moist mucous membranes, multiple well-healed […]