I can't make heads or tails of this question

This is not a homework question. My friend who is now an intern sent me this question. He said it was an "excellent" question to summarize what you "should have learned in your first year." I read the question and I think he might be trolling me. This is the kind of guy who would find it hilarious to send me on a wild goose chase, but he's also been helpful. I can't understand it at all, but maybe one of you can understand it? A 35 year old male presents to a rural health clinic with... I can't make heads or tails of this question
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums