A 36-year-old teacher presents to your clinic, complaining of sharp, knifelike pain on the left side of her chest for the last 2 days. Breathing and lying down make the pain worse, while sitting forward helps her pain. Tylenol and ibuprofen have not helped. Her pain does not radiate to any other area. She denies any upper respiratory or gastrointestinal symptoms. Her past medical history consists of systemic lupus. She is divorced and has one child. She denies any tobacco, alcohol or drug use. Her mother has hypothyroidism and her father has high blood pressure. On examination, you find her to be distressed, leaning over and holding her left arm and hand to her left chest. Her blood pressure is 130/70, her respirations are 12 and her pulse is 90. On auscultation her lung fields have normal breath sounds with no rhonchi, wheezes or crackles. Percussion and palpation are unremarkable. Auscultation of the heart has an S1 and S2 with no S3 or S4. A scratching noise is heard at the lower left sternal border, coincident with systole; leaning forward relieves some of her pain. She is nontender with palpation of the chest wall. What disorder of the chest best describes these symptoms

Cj is a 53 year old african american female presenting to pharmacy for first-time certification and cmr so that she may start getting her medications at no cost. cj states that her main concern about her health is her diabetes. pmh: t2dm, htn, hyperlipidemia sh: denies tobacco and illicit drug use, occasional alcohol use (1-2 drinks/month) fh: unknown allergies: penicillin (unknown reaction; had reaction when young). medications: lisinopril 5 mg daily aspirin 81 mg daily simvastatin 20 mg daily wt 231 lbs (105 kg), ht 5’6”, bmi 37.3 (obese), ibw 59.3 kg, bp 145/80, hr 98, random blood glucose 395, a1c 11.2%, estimated 10-year ascvd risk 9.5% drug-related problems: 1. uncontrolled t2dm 2. uncontrolled htn 3. suboptimal statin intensity 1) identify two pieces of objective data included in this case: 2) what kind of monitoring needs performed for the new prescription for this patient? 3) based on your case how would you counsel the patient on the new prescription medication? provide examples of specific aspects you would include in your patient education. 4) review your patient case. identify any medications that do not have a corresponding disease state. 5) review your patient case. identify any disease states are not treated by current medications. 6) what otc (over the counter) product would you recommend for this patient (based on the patient request for an otc product? include dose, frequency of administration, route of administration, and critical counseling points.