Author: Anonymous

A 27-year-old woman with systemic lupus erythematosus presents for routine follow-up. She states that her joint pain has improved, but over the past month she has noticed increasing fatigue and mild swelling around her ankles. Her blood pressure today is 148/92 mm Hg, compared with her usual reading of 112/70 mm Hg. Laboratory results reveal: Hemoglobin: 11.8 g/dL Serum creatinine: 1.3 mg/dL (previously 0.8 mg/dL) ESR: Elevated Which additional test would be most important to obtain at this visit?

A 68-year-old man presents with rapid swelling over the posterior aspect of his elbow. He reports fever and chills beginning the previous evening. Examination reveals marked erythema, warmth, fluctuance, and pain over the olecranon bursa. What is the most appropriate next step?

A 27-year-old man presents with low back pain that has gradually worsened over the past 8 months. He reports morning stiffness lasting approximately 90 minutes that improves after he bikes to work but worsens after prolonged sitting. He denies any specific injury. Which feature is most suggestive of inflammatory back pain associated with ankylosing spondylitis?

A 51-year-old man presents with fatigue, weight loss, intermittent fevers, diffuse muscle aches, and new numbness of his right foot. The nurse practitioner suspects a systemic vasculitis. Which additional findings would support this diagnosis? Select all that apply.

A patient with bulimia nervosa is at greatest risk for which electrolyte abnormality?

A nurse practitioner is obtaining a focused pain history from a patient with acute shoulder pain. The provider asks, “What makes the pain better or worse? Is there anything that triggers it?” Which component of the PQRST pain assessment is being evaluated?

A 71-year-old man presents with acute onset of a swollen, painful right knee. He denies trauma. He has known osteoarthritis of both knees and received an intra-articular corticosteroid injection 5 days ago. Temperature is 38.3°C (100.9°F).  What is the next best step?

A patient has a burn with blisters, moist pink skin, and severe pain. Which type of burn is most likely?

Match the physical examination maneuver with the condition it is most useful for identifying.

72-year-old woman develops a diffuse skin rash several days after starting a new medication at the recommended dose. Which mechanism most likely explains this adverse drug reaction?