nario M.S., a 72-year-old white woman, comes to your clinic for a complete has not been to a provider for 11 years becau

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Nario M S A 72 Year Old White Woman Comes To Your Clinic For A Complete Has Not Been To A Provider For 11 Years Becau 1 (160.96 KiB) Viewed 47 times

nario M.S., a 72-year-old white woman, comes to your clinic for a complete has not been to a provider for 11 years because I don't like doctors." Her n in my upper back." She describes the pain as sharp and knifelike. The pa eeks ago when she was getting out of bed in the morning and hasn't chan as 6 on a 0-to 10-point pain scale and says the pain decreases to 3 or 4 a rofen." She denies recent falls or trauma. M.S. admits she needs to quit s cising but states, "I don't have the energy to exercise, and besides, I've al ked one to two packs of cigarettes per day since she was 17 years old. He ears ago, and she can't remember the results. She went through menopa ever taken hormone replacement therapy. The physical examination fir than moderate tenderness to deep palpation over the spinous proces Erness to the tissue surround the tender spot. No visible masses, skin ch . Her neurologic findings are intact, and no muscle wasting is noted.