A 62 Y/O M with a Hx of CAD and a recent NSTEMI 3 months ago presents for follow-up. He has smoked 1.5 packs/day x40 yrs. O/E: BP 145/90 mmHg, HR 88 bpm. When you broach the topic of smoking cessation, he becomes defensive, stating, "Doctor, with all due respect, my father smoked his whole life and lived to be 90. These cigarettes are the only thing that helps me with my stress. I have no intention of quitting." Which of the following stages of the Transtheoretical Model of Change does this patient currently represent?

A 40 Y/O F with a known Hx of IBS and tension headaches c/o recurrent episodes of palpitations, chest tightness, and SOB over the past month. Each episode is abrupt in onset, lasts approximately 15 minutes, and is associated with intense fear of dying. O/E during a symptom-free period in the clinic reveals normal vital signs. Cardiac, respiratory, and neurological exams are unremarkable. Initial Ix, including a 12-lead ECG, CBC, and TSH, are all within normal limits. What is the most likely diagnosis?

An 82 Y/O F with a Hx of osteoporosis and dementia is brought to the ED by her caregiver due to confusion, constipation, and generalized weakness x1W. O/E: The patient is lethargic and dehydrated. BP 150/95, HR 105, RR 16. Ix labs reveal: Serum Ca²⁺ 13.8 mg/dL (high), PO₄³⁻ 5.1 mg/dL (high), Creatinine 1.9 mg/dL (high). Further tests show a markedly ↑ 25-hydroxyvitamin D [25(OH)D] level at 180 ng/mL and a suppressed PTH level. Which of the following is the most likely underlying cause of this patient's presentation?

A 62 Y/O postmenopausal F presents to the clinic c/o bilateral knee pain for the past year, worse with activity & relieved by rest. She is concerned about "weak bones" due to her Hx of smoking (20 pack-years) & intermittent inhaled corticosteroid use for asthma. O/E, there is crepitus on passive flexion of both knees. A recent DEXA scan was ordered, revealing a T-score of +2.0. What is the most likely diagnosis explaining her primary complaint?

A 58 Y/O M presents with a clean, minor laceration on his index finger from a kitchen knife. His immunization status is unknown, but he is certain he has not received any vaccines in at least 15 years. The wound is cleaned and sutured in the clinic. Which of the following is the most appropriate immunoprophylaxis to administer to this patient?

A 49 Y/O African M, a known hypertensive on Rx, requests routine HIV testing during a clinic visit. Fx Hx is positive for stroke & HTN. O/E: BP 155/95 mmHg, HR 82/min, BMI 31 kg/m ². Abdominal exam is limited 2° to obesity. Which set of initial Ix is most appropriate for this patient's comprehensive health screening?

An 18 Y/O university student c/o severe sore throat, fever (38.9°C), and profound malaise x4D, forcing him to miss classes. O/E: Marked tonsillar exudate and palatal petechiae are visible. There is tender posterior and anterior cervical lymphadenopathy. Abdominal exam reveals mild splenomegaly. A rapid strep test performed in the clinic is negative. What is the most likely Dx?

A 68 Y/O F with a Hx of a large anterior MI one year ago presents to the clinic c/o gradually worsening dyspnea on exertion and bilateral ankle swelling over the past 3 months. O/E: JVP is elevated to 5 cm, bibasilar crackles are heard on lung auscultation, and 2+ pitting edema is present up to the mid-shins. An echocardiogram is performed. The echocardiogram shows a left ventricular ejection fraction (LVEF) of 30% with akinesis of the anterior wall. Which of the following is the most accurate diagnosis?

An 82 Y/O M is brought to the clinic by his family due to recent falls and memory decline. His wife notes he has also developed urinary incontinence over the past few months. O/E, the patient walks with slow, wide-based, "magnetic" steps. When asked to turn, he takes multiple small steps, turning his whole body as a single unit. There is no resting tremor. What is the most likely diagnosis?