A Breast Lump

A 62-year-old man visits his physician with a complaint of a breast lump. On examination, there is no fever and vital signs are within normal limits. There is a hard lump in his right breast and nipple retraction. What is the most appropriate next step of action? A-X-Ray of the chest B-Ultrasound guided biopsy C-Mammography … Read more

Heart Murmur

An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. … Read more

Knee Discomfort

A 26-year-old woman visits her physician with a complaint of discomfort in her left knee for 2 weeks. It is exaggerated when she is sitting for a long time and relieved with analgesics. She admits that she had this discomfort on and off since she was at high school. On examination, the left knee does … Read more

Irregular Menstrual Periods

A 32-year-old woman with a long history of irregular menstrual periods visits her physician for consultation. She is married for 8 years and has been unable to conceive. Her menstrual period occurs once every 2-4 months.  She had normal Pap smear last year. Her height is 5.2″. Her weight is 205 pounds. Her vital signs … Read more