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Discussion Starter #1
A 6-year-old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year.
What is the most appropriate therapy for this girl?
A- Tetanus toxoid
B- Tetanus antitoxin
C- Both tetanus toxoid and antitoxin
D- Neither tetanus toxoid or antitoxin

Answer and Explanation

A 65-year-old farmer presents to your clinic complaining of shortness of breath for 6 months. Last 2 weeks he noticed that he has to get up several times during the night to be able to breath. He proudly tells you that he had never visited a doctor before although he smokes and drinks every night. On physical examination, there is displaced point of his maximum impulse, rales over both lungs and enlarged liver. Echo shows both right and left ventricular dilation and EF 30%. Laboratory test are normal except high bilirubin, AST 245 and ALT 180.
What is the initial cause of this patient presentation?
C-Lyme disease
D-Chronic hypertension
E-High cholesterol

Answer and Explanation
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