A 50-year-old woman presents for follow-up on recent lab tests obtained at a health maintenance visit. She reports feeling well and denies fatigue, weight changes, constipation, cold intolerance, palpitations, or changes in mood. She was recently diagnosed with subclinical hypothyroidism.

Which of the following would be her expected lab results?

A. TSH of 8.6, elevated free T4 of 14, which is normal.

B. TSH of less than 0.15, undetectable. Free T4 of 79, markedly elevated.

C. TSH of 24, elevated. A free T4 of three, markedly reduced.

D. TSH of 1.8, which is normal and a free T4 of 14, also normal.

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A 29-year-old otherwise healthy adult presents with a five-day history of nasal congestion, clear to white rhinorrhea, sore throat, and dry cough. She also denies dyspnea, pleuritic chest pain, GI upset, or fever. The patient is in no acute distress. Vital signs are temperature 99.2 Fahrenheit or 37.3 degrees centigrade. Respiratory rate is 16. O2 sat is 98 % on room air. Physical exam reveals mild pharyngeal erythema without exudate, no lymphadenopathy and tympanic membranes within normal limits. Lung resam is unremarkable except for occasional cough. The nurse practitioner diagnoses a viral URI or a common cold. The patient states, “I have trip coming up in five days, and I'm really worried that I might have the start of a sinus infection or pneumonia or a strep throat.”

The NP considers which of the following in addressing the patient's concerns?

A. if you start to cough up phlegm within the next day or so, this could indicate the start of a pneumonia

B. If your nasal discharge turns to green or dark yellow, this usually indicates that an antibiotic is needed

C. your cough could persist for a couple of weeks, which is quite common in a viral respiratory tract infection

D. if your sore throat persists for two to three more days, it means that a strep infection is starting

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A six-month, two-week-old infant who was born at 40.5 weeks gestation after an uneventful pregnancy is brought in for a well child visit. His parents mentioned, “his older sister was a really different baby. I think he's not quite where she was in his development at this age.” Which of the following would not be a red flag requiring further evaluation?

A. Inability to roll in either direction

B. Unable to transfer objects hand to hand

C. Reaches for objects with one hand

D. Ability to sit briefly without support

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YouTube: https://www.youtube.com/watch?v=hR4oy4NXV5s&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=146

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