Sports physical (pediatrics) Quiz: Ace Your Exams
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A 15-year-old boy presents to the primary care office for a sports physical for participation on his high school basketball team. He is accompanied by his parent, and they have no current concerns. The patient does not have a significant past medical history and does not take any medication. His past surgical history consists of a left orchiectomy at 7 years of age following a bicycle accident. One of the patient’s parents drowned unexpectedly at age 39 while swimming. The other parent is 48 years old and has no significant past medical history. The patient does not have siblings. Temperature is 37.0°C (98.6°F), heart rate is 81/min, respiratory rate is 18/min, blood pressure is 116/70 mmHg, and oxygen saturation is 99% on room air. Body mass index (BMI) is 20 kg/m2 (57th percentile for age). Cardiovascular examination reveals a harsh systolic murmur at the left sternal border which increases in intensity with Valsalva maneuver. Musculoskeletal and neurological examinations are within normal limits. A chaperoned genital examination confirms the absence of the left testicle but is otherwise normal. Electrocardiogram (ECG) demonstrates non-specific ST changes. Which of the following is the best next step in management?
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