A 58-year-old female with a history of diabetes type 2, hyp…

 A 58-year-old female with a history of diabetes type 2, hypertension and high cholesterol presents to your office for follow-up visit. She reports that overall, she is feeling well. Her blood sugars have been controlled, and she denies any hypoglycemic events.  On PE, her blood pressure is 155/92, HR is 76, RR 16, O2 Sat is 100% on RA. Her labs show decreased GFR of 55 with proteinuria and her A1c is 6.2. She currently takes Glucophage 500mg twice a day, HCTZ 25mg daily and Atorvastatin 80mg.  What would your next step in management of this patient be?

A 42-year-old male with no medical history presents to the o…

A 42-year-old male with no medical history presents to the office complaining of pain in his left great toe starting 2 days ago. He indicates that he is unable to walk and is in a wheelchair. He denies any trauma to the toe or foot. The toe is red, swollen, exquisitely tender and he is unable to extend it. You review his chart and note that he has been married for 20 years, works as a auto salesman and drinks a 6 pack of beer daily. He is allergic to ibuprofen. Select the best treatment from the options listed below. 

A 45-year-old post-menopausal Asian woman presents to the of…

A 45-year-old post-menopausal Asian woman presents to the office for a physical. She has blood pressure readings of 146-149/84-86 documented over 2 months on three separate occasions. She has no other medical conditions. Her ECG and creatinine are normal and she has no proteinuria.  She has trace lower extremity edema bilateral.  Clinical findings in today’s office visit are BP 145/88, HR 62, BMI 26, RRR, S1, S2. She has no S3, S4 heart sounds or murmur. The point of maximal impulse is at fifth intercostal space, mid-clavicular line.  Which of the following represents the best treatment for her high blood pressure?

A 35-year-old female presents to the office complaining of l…

A 35-year-old female presents to the office complaining of lower back pain for the past 5 days. She indicates the pain goes down the right side of her leg and has “pins and needles” feeling that comes and goes. On exam, she has a positive straight leg test on the right side but otherwise everything else is normal. What is the appropriate treatment?

A 37-year-old male with no significant past medical history…

A 37-year-old male with no significant past medical history presents to the office complaining of pain in his left metatarsal-phalangeal joint which started last night. He reports that it is so painful that he can barely walk. On exam, the joint is red, hot and tender.  What medication would you treat this patient with?