A mother presents to the family physician with her 16-year-old son. She explains, "There's something wrong with him doc. His grades are getting worse, he's cutting class, he's gaining weight, and his eyes are often bloodshot." Upon interviewing the patient apart from his mother, he seems withdrawn and angry at times when probed about his social history. The patient denies abuse and sexual history. What initial test should be sent to rule out the most likely culprit of this patient's behavior?
AComplete blood count
BSexually transmitted infection (STI) testing
CBlood culture
DUrine toxicology screen
ESlit lamp examination
A 70-year-old woman presents to the office for a yearly physical. She states she has recently started experiencing pain in her legs and her back. Last year, she experienced a fracture of her left arm while trying to lift groceries. The patient states that she does not consume any dairy and does not go outside often because of the pain in her legs and back. Of note, she takes carbamazepine for seizures. On exam, her vitals are within normal limits. You suspect the patient might have osteomalacia. Testing for which of the following is the next best step to confirm your suspicion?
AVitamin D2 (ergocalciferol)
B25-hydroxyvitamin D
CPre-vitamin D3
D1,25-hydroxyvitamin D
E7-dehydrocholesterol
A 61-year-old Caucasian woman comes to the physician for a routine health maintenance examination. She feels well. She had a normal mammography 10 months ago and a normal serum lipid profile 3 years ago. Two years ago, a pap smear and testing for human papillomavirus were performed and were negative. She had a normal colonoscopy 6 years ago. HIV testing at that time was also negative. Her blood pressure and serum blood glucose were within normal limits during a routine visit 6 months ago. She is a retired university professor and lives together with her husband. She has no children. Menopause occurred 7 years ago. Her father developed colon cancer at the age of 75 years. She does not smoke or drink alcohol. Her only medication is a daily multivitamin. She is 163 cm (5 ft 4 in) tall and weighs 58 kg (128 lb); BMI is 22 kg/m2. Which of the following health maintenance recommendations is most appropriate at this time?
ASerum HIV testing
BReassurance
CColonoscopy
DFecal occult blood test
EDual-energy x-ray bone absorptiometry
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