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[Verified Answer]: Scenario 4 SUBJECTIVE Patient is 19-year-old…

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Scenario 4 SUBJECTIVE Patient is 19-year-old male with heroin addiction, admitted with heroin toxicity. He admits to continuous heroin use and has tried methadone as well as weaning from methadone with no success. OBJECTIVE Patient lacks insight into his drug problem. He is otherwise healthy, other than needle marks on his extremities and obvious lack of hygiene. He shows obvious signs of depression. ASSESSMENT Heroin addiction, depression. PLAN I discussed with the patient my unwillingness to prescribe controlled substances or narcotics for him, due to his drug use issues. However, I do feel his depression demands treatment, so I am prescribing fluoxetine 20 mg 1 tab daily. I discussed potential side effects in detail. I also warned him that all antidepressant medications carry increased risk of suicide. I instructed the patient to contact outpatient behavioral services to continue his substance abuse treatment. Patient agreed to do this. ICD-10-PCS: _____ 19. Scenario 5 REASON FOR EXAM Prostate cancer. PRIMARY PROCEDURE WHOLE-BODY RADIONUCLIDE BONE SCAN. PROCEDURE After 3.5 hours of the intravenous administration of 26.5 mCi of technetium 99m MDP, the skeleton was imaged in the anterior and posterior projections. There appears to be a focus of abnormal increased tracer activity overlying the right parietal region of the skull. The uptake in the remainder of the skeleton is within normal limits and the kidneys image normally. There is increased activity in the urinary bladder, which may suggest possible urinary retention. There appears to be a focus of abnormal increased tracer activity overlying the right parietal region of the skull. CT scan of magnetic resonance imaging of the skull and brain is recommended for further assessment if it is clinically indicated. ICD-10-PCS: _____

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