Discussion 1

 A 65 yr old African American patient presents to the health facility because her wife insisted he comes in to have a complete exam done. Patient has not sought health care in “many years.” Although he feels well, he only complains of “heartburn” when he “lays down to sleep at night”


A 34-y.o. female presents with the complaint of a sudden excruciating pain in her back and points to her flank area on the right side. She rates the pain as 10 on a scale of 1 to 10, with 10 being the worst. She also complains of nausea with the pain. She states that she has never had anything like this before, and the pain is subsiding a little now.


A 52-year-old man presents with classic signs and symptoms ofperiph­ eral venous insufficiency. It is bilateral, chronic, and dependent and without signifi­ cant constitutional, cardiac, or pulmonary symptoms. Physical examination reveals varicosities and venous stasis dermatitis. The edema often interferes with and is aggravated by his work and is possibly worsened with the recent use of ibuprofen.


Summary: A 62-year-old man presents to your office for a routine checkup. He reports having occasional bloody stools and you discover guaiac-positive stools. He is a bit pale, but hemodynamically stable at the moment. You decide that further evaluation ofthis bleeding is necessary, but most ofit can be carried out on an outpatient basis with close follow-up.