A 36-Year-Old Woman Comes to the Office for Evaluation of Fatigue

question 1352

Multiple Choice

A 36-year-old woman comes to the office for evaluation of fatigue and generalized weakness for the past several weeks.  She has had no appetite or weight changes, heat or cold intolerance, nausea or vomiting, or constipation.  The patient's medical and family histories are unremarkable.  Temperature is 36.7 C (98 F) , blood pressure is 120/70 mm Hg, pulse is 76/min, and respirations are 14/min.  Physical examination shows normal heart and lung sounds, an unremarkable abdominal examination, and no focal neurologic deficits.  Laboratory results are as follows: Which of the following is the best next step in management of this patient?

• A)Parathyroid scintigraphy
• B)Plasma fibroblast growth factor 23 level
• C)Plasma parathyroid hormone-related protein level
• D)Radiographic skeletal survey
• E)Serum 25-hydroxyvitamin D level
• F)Serum alkaline phosphatase level

Understand the development of visual and auditory perception in infancy.

Grasp the concept of phonemic distinctions and its relevance to language acquisition.

Understand the importance and types of skills necessary for salesperson success (human, technical, and conceptual skills).

Identify and avoid the "seven deadly sins of business selling."

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Definitions:

Negative Thoughts

Mental processes characterized by pessimism or a focus on undesirable outcomes or experiences.

Geert Hofstede

A Dutch social psychologist who made a significant contribution to the understanding of cultural differences through his development of cultural dimensions theory.

Masculine Culture

refers to a societal or organizational culture that values traditional masculine traits such as assertiveness, competitiveness, and dominance.

Expatriates

Individuals who live outside their native country, often for work reasons, and face unique challenges and opportunities.