1. NR 508 Teaching Effectively-- snaptutorial.com

2. NR 508 Week 1 Discussions For more classes visit www.snaptutorial.com Discussion Part One Emily, a relatively healthy 5’5”, 32-year-old young woman weighing 190 pounds, presents to your clinic with hirsutism, anovulation, oligomenorrhea, and at times amenorrhea. Biochemical blood tests reveal elevated luteinizing hormone (LH, without a mid-cycle surge) and androgen elevation.

3. NR 508 Teaching Effectively-- snaptutorial.com NR 508 Week 2 Discussions For more classes visit www.snaptutorial.com Discussion Part One Cynthia is a 65-year-old African American female who presents to the clinic for a check-up. Her last examination was ~5 years ago. She has no specific, significant, or urgent complaint. She explains that her only issues are thirst, fatigue, and leg numbness and tingling, which is beginning to occur more often. You decide to do a physical exam, as well as draw labs and receive the following results:

4. NR 508 Teaching Effectively-- snaptutorial.com NR 508 Week 3 Discussions For more classes visit www.snaptutorial.com Discussion Part One Elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. The patient is also complaining of a runny nose, cough, and head/chest congestion. He has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. Approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. Below is a list of the patient’s medications, his physical examination, and his laboratory findings:

5. NR 508 Teaching Effectively-- snaptutorial.com NR 508 Week 4 Discussions For more classes visit www.snaptutorial.com Discussion Part One Barbara is a married 39-year-old woman with no children, smokes 1 pack/day, and weighs 180 pounds who has scheduled an appointment with you to discuss feelings of anhedonia that she has been experiencing for the past few months. She has a history of depression as a teenager, but has not needed or received therapy for ~20 years. At the appointment, she relays that she has been experiencing chronic fatigue/loss of energy, feelings of worthlessness, appetite disturbances, weight gain, inability to concentrate, psychomotor disturbances, and insomnia.

6. NR 508 Teaching Effectively-- snaptutorial.com NR 508 Week 5 Discussions For more classes visit www.snaptutorial.com Discussion Part One Leroy is a 70 year-old-man, whose wife passed away 5 years ago, and whose 2 children live out-of–state. His neighbor caretaker (Ms. Webb, a middle-aged retired CNA, whom his children hired to provide home care to him 3x/week) brings him to your clinic. He presents with quite severe confusion, incidentally to very minor changes in his environment, which provokes some violence (a symptom which startles Ms. Webb), increasingly impaired judgment, and increasing repetitiousness and inconsistencies in his usual behavior. Upon initial work-up and physical exam, you notice an increased respiratory rate, a slight fever (100°F), and cost vertebral angle tenderness on his right side.

7. NR 508 Teaching Effectively-- snaptutorial.com NR 508 Week 6 Discussions For more classes visit www.snaptutorial.com Discussion Part One Jonathon is a 56 year-old retired automobile mechanic who has not been to the doctor in approximately 6-7 years. He presents to your office complaining that 3 weeks ago he was awoken with severe pain and inflammation in his knee, which has been consistent since that initial night. Upon physical examination of his knee, it appears swollen and erythematous with periarticular involvement. Upon physical examination and laboratory results you notice the following:

8. NR 508 Teaching Effectively-- snaptutorial.com NR 508 Week 7 Discussions For more classes visit www.snaptutorial.com Discussion Part One Adam is an active, healthy 5’10” 34 year-old man weighing 145 pounds. He presents to your clinic with complaints of wheezing, dyspnea, cough, and sputum production, especially when running. He informs you that he is an avid marathon runner competing in one to two 5 or 10K runs per month. He tells you that he is symptomatic more than 2 times per week, but less that 1 times per day, and nighttime symptoms hardly ever occur. He also adds that his symptoms can get worse after and sometimes during his runs, especially when the outside temperature drops below 50°F.

9. NR 508 Teaching Effectively-- snaptutorial.com