MKSAP: 37-year-old man with low libido and fatigue
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history is otherwise unremarkable. He takes no medications.
On physical examination, vital signs are normal. BMI is 35. The remainder of the examination, including genital examination, is normal.
Laboratory studies:
| Luteinizing hormone | 10 …
MKSAP: 37-year-old man with low libido and fatigue MKSAP: 72-year-old man with cough and increasing dyspneaTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for a 2-year history of cough and a 1-year history of increasing dyspnea. He describes the cough as nonproductive, and his shortness of breath is worse with exertion. He does not have chest pain, orthopnea, paroxysmal nocturnal dyspnea, or any other symptoms. Medical history is otherwise unremarkable. … MKSAP: 72-year-old man with cough and increasing dyspnea MKSAP: 57-year-old woman is evaluated after a recent screening colonoscopyTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old woman is evaluated after a recent screening colonoscopy. The colonoscopy disclosed a 12-mm polyp in the ascending colon, which was removed. No other lesions were noted. On pathology, the lesion was found to be a sessile serrated polyp. Physical examination findings are unremarkable. Which of the following is the most appropriate time … MKSAP: 57-year-old woman is evaluated after a recent screening colonoscopy MKSAP: 36-year-old woman with facial painTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 1-week history of recurrent episodes of facial pain that are 1 to 3 seconds in duration and occur spontaneously dozens of times throughout the day. The pain is sharp, severe, and located in the right infraorbital area. During this same period, she has developed worsening … MKSAP: 36-year-old woman with facial pain MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasisTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for recurrent nephrolithiasis. Medical history is significant for Crohn disease complicated by multiple small bowel strictures requiring resection. He began developing kidney stones 3 years ago following his last bowel surgery. Analysis of the stones has consistently shown calcium oxalate, and he has been adherent to a … MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasis MKSAP: 57-year-old man is seen after results of a carotid ultrasoundTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is seen for follow-up evaluation after results of a carotid ultrasound obtained to investigate a left neck bruit show a mixed density plaque at the origin of the left internal carotid artery. Stenosis is estimated to be 60% to 80%. He has had no focal neurologic symptoms or visual … MKSAP: 57-year-old man is seen after results of a carotid ultrasound MKSAP: 29-year-old woman with nodules over her lower extremitiesTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 29-year-old woman is evaluated for a 5-day history of nodules over her lower extremities. She reports that she regularly visits a local spa that uses whirlpool footbaths during her pedicure procedures; she always shaves her legs with a razor before these visits. Medical history is unremarkable, and she takes no medications. On … MKSAP: 29-year-old woman with nodules over her lower extremities MKSAP: 68-year-old man with new-onset ascitesTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated for new-onset ascites with lower-extremity edema. Symptoms have increased gradually over the past 4 weeks. He has consumed three alcoholic beverages per day for many years. His medical history is notable for coronary artery bypass graft surgery 8 months ago and dyslipidemia. His medications are low-dose aspirin, atorvastatin, … MKSAP: 68-year-old man with new-onset ascites MKSAP: 44-year-old woman with a painless right neck massTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old woman is evaluated for a 2-month history of a painless right neck mass. Medical history is unremarkable, and she takes no medications. She is a lifelong nonsmoker. On physical examination, vital signs are normal. A 5-cm right anterior neck mass is palpated. The remainder of the examination is unremarkable. An initial CT scan … MKSAP: 44-year-old woman with a painless right neck mass MKSAP: 79-year-old man with right hip painTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 79-year-old man is evaluated for a 3-month history of right hip pain. He points to the center of his right buttock when asked to identify the location of the pain. He has no radicular symptoms. He reports no focal trauma but believes his symptoms began after he stepped off a curb that … MKSAP: 79-year-old man with right hip pain MKSAP: 52-year-old man with sudden onset of erectile dysfunctionTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated for the sudden onset of erectile dysfunction that has persisted for 6 months. He reports having erections that are inadequate for vaginal penetration. He feels guilty about not being able to satisfy his wife’s requests for sexual intercourse, although he still has sexual desires. He has been sleeping poorly … MKSAP: 52-year-old man with sudden onset of erectile dysfunction MKSAP: 81-year-old man after a percutaneous coronary interventionTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 81-year-old man is evaluated in the office 3 days following a percutaneous coronary intervention with placement of a bare metal stent in the left anterior descending artery for angina refractory to maximal medical therapy. He indicates that he feels well except for palpitations that were not present before the procedure. Medical history … MKSAP: 81-year-old man after a percutaneous coronary intervention MKSAP: 28-year-old man with elevated liver chemistry test resultTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated in follow-up for elevated liver chemistry test results, which were performed to assess a 3-month history of fatigue. He has no history of liver disease and has not had abdominal pain or fever. His medical history is significant for a 3-year history of diarrhea. Following a physical exam, … MKSAP: 28-year-old man with elevated liver chemistry test result
ADVERTISEMENT MKSAP: 67-year-old man with primary hyperparathyroidismTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril. On physical examination, temperature is 35.8 °C (96.4 °F), blood pressure is 120/68 mm Hg, pulse rate … MKSAP: 67-year-old man with primary hyperparathyroidism MKSAP: 30-year-old woman with diarrheaTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in the stool. She works … MKSAP: 30-year-old woman with diarrhea MKSAP: 55-year-old man with goutTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a follow-up visit for gout. Two years ago, he had been treated with allopurinol and developed a hypersensitivity reaction. Over the past several months, he has had recurrent attacks of acute, episodic swelling of the first metatarsophalangeal joints with increasing involvement of other joints, including the ankles … MKSAP: 55-year-old man with gout MKSAP: 74-year-old woman with altered mental statusTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old woman is evaluated in the emergency department for several hours of altered mental status. She is from out-of-state and is visiting with relatives. One of her young relatives was recently ill with gastrointestinal symptoms. The patient developed anorexia 3 days ago and vomiting 2 days ago. She has been unable to … MKSAP: 74-year-old woman with altered mental status MKSAP: 67-year-old man with worsening exertional dyspneaTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a 6-month history of worsening exertional dyspnea. He has a history of severe COPD diagnosed 4 years ago and previously had minimal exertional symptoms. However, he now notes shortness of breath when walking short distances that is limiting his activity level. He does not have chest pain, … MKSAP: 67-year-old man with worsening exertional dyspnea MKSAP: 45-year-old man with cough and right-sided chest discomfortTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated for right-sided chest discomfort and cough of 2 weeks’ duration. His chest discomfort is described as a vague, painful sensation on the right. The cough occasionally produces a small amount of sputum; he reports no hemoptysis or shortness of breath. He has felt feverish with mild fatigue but … MKSAP: 45-year-old man with cough and right-sided chest discomfort MKSAP: 68-year-old man with a right intertrochanteric fractureTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but no other symptoms. He has hypertension and type 2 diabetes mellitus and was in his usual state of health prior to the fall. He checks his blood glucose level several times … MKSAP: 68-year-old man with a right intertrochanteric fracture
Subscribe to KevinMD and never miss a story!Get free updates delivered free to your inbox. 22
pages
|
