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A 16-year-old man presents to the ED complaining of three days of nasal rhinorrhea, cough, myalgias, and generalized malaise. After a coughing episode yesterday, he developed pleuritic chest pain radiating to the left neck. His vital signs are BP 130/70 mm Hg, HR 76, RR 16, T 36.6°C and pulse oximetry 98% on room air. You obtain the chest radiograph seen above. Which of the following is the most appropriate next step in management?

Which of the following patients mandates reporting to health authorities in all 50 states or to federal officials?

A 36-year-old man presents with severe eye pain, tearing, and photophobia. His fluorescein exam is shown above. Which of the following is the most likely cause of his symptoms?  

A 59-year-old Chinese immigrant presents with a new, diffuse skin rash and facial swelling. The patient was discharged three weeks ago after suffering a myocardial infarction. His hospitalization was complicated by an episode of gout. On exam, he has significant facial edema without throat swelling or difficulty breathing. He also has a morbilliform rash with scattered bullae. His home medications include aspirin, metoprolol, lisinopril, clopidogrel, atorvastatin, allopurinol, and esomeprazole. His laboratory results are as follows: WBC 11,900/uL, neutrophils 63%, lymphocytes 17%, eosinophils 14%, BUN 48 mg/dL, creatinine 2.4 mg/dL, AST 28 U/L, ALT 102 U/L, alkaline phosphatase 98 U/L. Which medication is the likely etiology of his symptoms?

A 33-year-old man presents to the ED with a 2-day history of a cough with rust-colored sputum, fever, and chills. He has no past medical history and has had no recent illnesses or hospitalizations. In the ED, his vital signs are BP 120/76, HR 102, RR 22, oxygen saturation 97% on room air, and temperature 102.2°F. A chest X-ray shows a right lower lobe consolidation. The patient is diagnosed with pneumonia. What is the most likely pathogen?

What is the most common malignancy presenting in children younger than 15 years of age?

A 65-year-old man presents with ringing in his ears. He takes a number of medications. Which of the following medications is known to cause tinnitus at toxic levels?

A 30-year-old man presents to the ED with three weeks of diarrhea. He reports colicky abdominal pain associated with frequent episodes of pale, loose, foul-smelling stools. He returned from a camping trip in New Hampshire one month prior. His vital signs are temperature 37.1°C, heart rate 85, blood pressure 125/80 mm Hg. Which of the following is the most appropriate treatment for this condition?

An 83-year-old man with a history of diabetes and hypertension complains of numbness and severe pain in his left thigh. The pain began yesterday as a dull ache, but has rapidly increased in intensity and is now 10/10. Vital signs are BP 102/48 mm Hg, RR 24, HR 112, oxygen saturation 98% on room air, and a T of 40.3°C. Physical exam reveals tender, edematous, erythematous purpuric patches, and scattered bullae filled with serosanguineous watery fluid on his left thigh. Complete blood count reveals WBC of 15.8/µL with 31% bands, hemoglobin of 10.6 g/dL, a hematocrit of 31.8%, and platelets of 98/µL. Metabolic panel is significant for calcium of 8.4 mg/dl. Which of the following is the most appropriate next step in management?

An 82-year-old nursing-home resident is sent to the emergency department with lower abdominal pain and bloody diarrhea. He has a history of vascular dementia, hypertension, and hyperlipidemia. On examination he is afebrile, and a nasogastric aspirate is negative for evidence of bleeding. Which of the following is the most likely cause of this patient’s bleeding?