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Mrs. Pratt, your 52-year-old patient is obese and unable to look directly at the bottoms of her feet to assess for skin problems related to diabetes. What could you, as her PCP, suggest that might help her complete her foot assessment?
A 27-year-old woman with a history of bulimia nervosa comes to the clinic with a complaint of chest pain. The patient describes the pain as sharp, substernal, and occurring during an episode of vomiting.
On exam, the patient appears ill and diaphoretic. Vital signs show a blood pressure 135/85, pulse of 90, respiratory rate of 30, temperature of 98.6, and oxygen saturation of 98% on room air. The remainder of the physical exam is ordinary. Laboratory tests are normal.
Chest x-ray shows a small left pleural effusion.
What is the next best diagnostic step?
Your client is a 33 year old woman of Central American descent. She has rough red skin due to sun exposure, which she has been developing for a couple of years. Also, she is suffering from chronic, watery diarrhea. It has been shown in her physical examination that she is showing signs of memory loss and confusion. What nutritional deficiency could be causing her issue?