A rural community college has requested your guidance in offering a preventive health program to its students. The most appropriate plan would include which one of the following?

A 72-year-old male has newly diagnosed systolic heart failure due to hypertensive cardiomyopathy. The patient has an estimated left ventricular ejection fraction of 30% and was dyspneic at rest and with minimal exertion at the time of diagnosis.

Which one of the following drugs is indicated to reduce mortality in this patient?

A 65-year-old female develops gram-negative septicemia from a urinary tract infection. Despite the use of fluid resuscitation she remains hypotensive, with a mean arterial pressure of 50 mm Hg.

Which one of the following would be the most appropriate treatment for this patient?

A 20-year-old female visits your office for advice regarding contraceptives. She expresses interest in long-acting reversible contraception (LARC).

Which one of the following is the recommended timing for LARC placement?

A 55-year-old male with chronic paranoid schizophrenia, mild intellectual disability, and hypertension is brought to your office with foot pain. He resides in a personal care home and is accompanied by his caregiver, who says the patient had pain this morning and could not walk. His medications include hydrochlorothiazide, lisinopril (Prinivil, Zestril), risperidone (Risperdal), and metformin (Glucophage). On examination he has an erythematous, warm, tender metacarpophalangeal joint of his right great toe. He refuses joint aspiration but does agree to allow blood work. A CBC and metabolic profile are both normal and his uric acid level is 6.8 mg/dL (N 3.4–7.0).

Which one of the following is the most likely diagnosis?

A 33-year-old female with a BMI of 35.2 kg/m2 presents to your office for follow-up of her recently documented blood pressure elevation. Her blood pressure is elevated again today. You diagnose hypertension and decide to start pharmacologic therapy in addition to lifestyle modifications.

Which one of the following agents would be the best first-line choice for this patient?

A 60-year-old male presents with a 6-week history of worsening bilateral shoulder, upper arm, and neck pain. He has morning stiffness that lasts at least an hour. The review of systems is otherwise negative. There is no localized tenderness or motor weakness on physical examination. His erythrocyte sedimentation rate is 55 mm/hr.

Which one of the following is the best treatment option for this patient at this time?

A 20-year-old male college student comes to your office to ask what he can do to prevent meningitis. His roommate was just hospitalized with invasive meningococcal disease. The patient has no symptoms at this time, a physical examination is normal, and he received meningococcal vaccine at the recommended times. He lives in a campus dormitory that houses 22 students.

Which one of the following would be most appropriate?

A 43-year-old female presents with marked proximal muscle weakness, dysphagia, and pain in the shoulders and hips, all beginning within the past 5 weeks. She reports difficulty getting out of a chair. On examination she has a violaceous rash involving the periorbital skin, and macular erythematous lesions over the anterior chest and upper lateral thighs.

Which one of the following additional findings would you expect?