FA Cases

Question 1

Case #27

William Jordan, a 61-year-old male, comes to to the office complaining of fatigue.

BP: 135/85 mm Hg
Temp: 98.6°F (37°C)
RR: 13/minute
HR: 70/minute, regular

Answer 1

Diagnosis #1: Pancreatic cancer
Diagnosis #2: Major depressive disorder
Diagnosis #3: Chronic pancreatitis

• CBC with differentials, stool for occult blood
• Glucose
• Fecal fat studies
• Amylase, lipase
• AST/ALT/Bilirubin (direct, indirect, and total)/Alkaline phosphatase
• CT-abdomen

Question 2

Case #33

Gary Mitchell, a 46-year-old male, comes to the office complaining of fatigue.

BP: 120/85 mm Hg
Temp: 98.2°F (36.8°C)
RR: 12/ minute
HR: 65/minute, regular

Answer 2

Diagnosis #1: Major depressive disorder
Diagnosis #2: Hypothyroidism
Diagnosis #3: Posttraumatic stress disorder

• TSH
• CBC
• Serum chemistry panel
• HIV antibody

Question 3

Case #34

Jessica Lee, a 32–year-old female, comes to the office complaining of fatigue.

BP: 120/85 mm Hg
Temp: 98.2 °F (36.8° C)
RR: 13/minute
HR: 80/minute, regular

Answer 3

Diagnosis #1: Domestic violence
Diagnosis #2: Diabetes mellitus
Diagnosis #3: Anemia

• Serum glucose, HbA1c
• CBC
• Serum iron, ferritin, TIBC, serum 812
• UA
• Electrolytes

Question 4

Case #32

Virginia Blade, a 6 yo comes to the clinic complaining of forgetfulness and confusion.

BP: 135/85 mm Hg
Temp: 98.0 °F (36.7° C)
RR: 16/minute
HR: 76/minute, regular

Answer 4

Diagnosis #1: Alzheimer disease
Diagnosis #2: Vascular dementia
Diagnosis #3: Depression with pseudodementia

• CT head or MRI brain
• EEG or SPECT
• CBC with differential
• Serum B-12, TSH, RPR
• Electrolytes, calcium, glucose, BUN/Cr

Question 5

Case #35

Jade Edwards, a 27 yo male, comes to the ED complaining of seeing strange writing on the wall.

BP: 140/80 mmHg
Temp: 98.3 °F (36.5 °C)
RR: 15/minute
HR: 110/minute, regular

Answer 5

Diagnosis #1: PCP intoxication
Diagnosis #2: Substance-induced psychosis

• Urine toxicology
• Electrolytes
• CPK
• Urine myoglobin
• Mental status exam

Question 6

Gwen Potter, a 20 yo female, comes to the clinic complaining of sleeping problems.

BP: 120/80 mm Hg
Temp: 98.6 °F (37 °C)
RR: 18/minute
HR: 102/minute

Answer 6

Diagnosis #1: Generalized Anxiety Disorder
Diagnosis #2: Caffeine-induced insomnia
Diagnosis #3: Hyperthyroidism

• TSH, T3, T4
• CBC with differentials
• Urine toxicology
• Polysomnography
• ECG