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Question

You are seeing Michael "Jazzy" Myer today at clinic. The chief complaint is "I need my medications refilled" on

the chart.  Jazzy is a Puerto Rican transgender male to female patient who is new to the practice. She has been scheduled for a 15-minute appointment today so you know you will need to address the problem for today and schedule a return new patient visit. The patient has a history of hypertension, chronic kidney disease, chronic pain, and diabetes type 2.

Medications

·       Estradiol Valerate 60 mgs IM q 2 weeks

·       Sprionolactone  200 mgs PO q day

·       Amlodipine 10 mgs PO q day

·       Vicodin 7.5 mgs q 6 hours PO prn pain

·       Metformin 1000 mgs PO BID q day

After you open the interview and invite the patient to tell her story, Jazzy says, "I was just release from San Quentin a week ago and I have been out of my medication since I was arrested 2 years ago." I really need my pain medication and Valium. I am so nervous.

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