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Will, a 24 year-old African American male, has a rash on the arm.  The rash began as red and round and is itchy and now it has spread.  On exam, you note a single, well demarcated, erythematous, scaly annular lesion with central clearing on his arm.  Based on this information only, what would be the MOST LIKELY diagnosis?

Jennifer is a 47yo patient recently diagnosed with DM2. She recently completed a comprehensive eye exam, including a dilated retinal exam. The examination was “normal”. When would you counsel her this exam needed to be repeated? 

A 45y/o female comes to be evaluated for thickened toe nails that have gotten worse over the last 6 months.  She states that they developed after her family got a hot tub.  She used over the counter nail polish to treat them but they have not changed.  On exam you note thickened toe nails with white patches on the lateral edges with chalky debris noted when you scrape the nails.  What would be the proper treatment for her condition?

* Jing is an 18 mos old infant brought in by her mother with a C/O fussy child with a fever of 100. Past Health Hx – According to mother and chart, recurrent otitis media. No hospitalizations.Social Hx – Stays at daycare when mother working.Present Complaint – four days ago she took her to the ER where she was given a 10-day course of some “pink” medicine (amoxicillin), prescribed for her ears Your exam finds her left tympanic membrane (TM) is red and bulging, has decreased mobility and fluid is present. There is a white patchy area on her palate that is positive for candida Albicans with a KOH prep. Of the following, which would be the best treatment at this time?

Linda has come in for follow-up on her recent labs. She is 66 inches in height, weighing 200 pounds. Her fasting plasma glucose level is 198 mg/dL. You are diagnosing her with type 2 diabetes mellitus (DM). . What is the best initial treatment?

*You are working in the urgent care and a 3 y/o presents with their parents with new onset nosebleeds and blood blisters in her mouth. Per the history she has been healthy except for a cold in the last 2 weeks that resolved without any issues. You get a CBC and she has a platelet count of 10,000. Which of the following diagnoses should you suspect?

*Alan, a 17 year old male, has an elevated B/P reading while in the office for a shoulder injury. B/P is 144/92. Mom and dad both have hypertension. Your next action is to:

Ms. Young is 41 years old and has found a mass in her right breast which she comes to you for and you also feel the mass.  What test(s) should be ordered by the NP?

Jessie, age 29, experiences photophobia about 20 minutes before experiencing severe headaches.  The headaches are unilateral and throbbing along with nausea. How would you describe her headache?Jessie, age 29, sees flashing lights 20 minutes before experiencing severe headaches in addition to nausea. How would you describe her headache?

*Megan presents with RUQ abdominal pain and she has a positive Murphy’s sign. You are suspecting that Megan is experiencing issues with her gall bladder.  What radiological test would you initially order?