A 15-year-old male has a 1-week history of a nonproductive cough, a low-grade fever, a sore throat, and hoarseness. His respiratory rate is 22/min but unlabored, his temperature is 38.1°C (100.6°F), and his O2 saturation is 94% on room air. A chest radiograph reveals bilateral interstitial infiltrates.
Which treatment would be most appropriate for this patient?
72-year-old female who remains very active and engaged in the community comes to your
office concerned by urinary symptoms that disrupt her life. She reports that she often has a
strong, abrupt desire to void that frequently causes her to leak urine involuntarily. She also
reports occasional episodes of urinary frequency and nocturia.
What is the first-line treatment for her condition?
An 82-year-old female with terminal breast cancer has been admitted to hospice care. She is having severe pain that you will manage with opioids.
What would be appropriate to recommend for preventing constipation?
A 20-year-old female distance runner presents with a 1-month history of left knee pain. The pain is worse with her first few steps in the morning and when going down stairs. Examination of the knee reveals no deformity, effusion, or ligamentous laxity. The knee joint and surrounding tissues are not tender to palpation, with the exception of an area 2 cm proximal to the left lateral joint line.
What is the most likely cause of this patient’s pain?
The mother of a 6-month-old male tells you that he sometimes wheezes while feeding, and this is occasionally associated with a cough. Changing his position does not help.
What is the most likely diagnosis?
A 63-year-old male with a history of alcoholism and compensated hepatic cirrhosis asks if there are pain medications he can use to treat his chronic low back pain and knee and hand osteoarthritis. He also has occasional headaches. He has not used alcohol for several years.
What medications is CONTRAINDICATED in this patient?
A 30-year-old male presents to your office with a 3-week history of nausea, weight loss, diarrhea, and hematochezia. He states that he has had similar episodes twice in the past and was treated at the local urgent care clinic for infectious diarrhea, with resolution of his symptoms. Your initial laboratory workup is negative for enteric pathogens and you refer the patient for colonoscopy and esophagogastroduodenoscopy with small bowel follow-through. The patient is found to have multiple noncontiguous transmural ulcerations throughout both the small and large intestines.
Which initial management strategies is most likely to induce remission in this patient?
Verticales
According to national and international guidelines, which one of the following is the next step for adults with asthma who require therapy with inhaled β-agonists more than three times a week?
A 41-year-old male presents with a complaint of headaches for the past 6 weeks. He has severe, sharp, right-sided periorbital pain 3–4 days each week. When these headaches occur his right eye gets watery, his right nostril feels clogged, and his forehead feels sweaty. When he gets the headaches he takes four 200-mg ibuprofen tablets and goes into a dark, quiet room. The headaches usually resolve in about 90 minutes. Currently he is feeling well and his examination is completely normal.
What type of headache does he most likely have?
A 15-year-old male presents to the emergency department at 10 p.m. with a 2-hour history of
severe, acute scrotal pain associated with vomiting. On examination the right testicle is swollen.
Ultrasonography is inconclusive.
What would be most appropriate at this point?
A 75-year-old female with a 10-year history of type 2 diabetes mellitus presents with moderate bilateral burning pain in the distal portion of her feet. Her hemoglobin A1c is 8.1%.
What is recommended as first-line therapy for improvement of this patient’s pain?
A 70-year-old white female asks you to evaluate her right shoulder because of pain and limited range of motion. Further history reveals that 2 months ago she slipped in her kitchen and caught onto the refrigerator door handle to avoid falling to the floor. On examination she has pain and weakness at 45° of abduction and weakness on external rotation.
She should be treated for?
What is associated with a herald patch?
A 22-year-old male who is training for a marathon presents with a 2-week history of ankle pain. There is no history of trauma to the ankle. Your examination reveals tenderness over the distal tibia and you suspect a stress fracture. What imaging?
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