A 40-year-old patient presents to your outpatient clinic with fever, diffuse headache, photophobia, and neck discomfort. Neurologic screening is nonfocal. You plan a focused bedside examination to evaluate for meningeal irritation. Which maneuver is most appropriate to perform now?
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A 34-year-old new parent has radial wrist pain with a positi…
A 34-year-old new parent has radial wrist pain with a positive Finkelstein test. What is the most appropriate initial treatment?
A 45-year-old man has fever, dysuria, perineal pain, and a v…
A 45-year-old man has fever, dysuria, perineal pain, and a very tender, boggy prostate on examination. What is the most appropriate next step?
A 58-year-old man with chronic low back pain for 10 months h…
A 58-year-old man with chronic low back pain for 10 months has tried exercise therapy and nonsteroidal anti-inflammatory medication with partial relief. He requests an opioid because “nothing else works.” He has no red flags, uses alcohol socially, and takes no sedatives. What is the most appropriate next step before considering any opioid trial?
A 36-year-old desk worker has bilateral band-like headaches…
A 36-year-old desk worker has bilateral band-like headaches linked to stress and poor sleep; neurologic exam is normal. What is the best initial plan?
A 67-year-old woman with diabetes has fever, flank pain, vom…
A 67-year-old woman with diabetes has fever, flank pain, vomiting, and appears ill. She cannot keep down fluids or medications. What is the most appropriate order?
A 64-year-old with knee osteoarthritis has posterior knee fu…
A 64-year-old with knee osteoarthritis has posterior knee fullness and discomfort; ultrasound shows a popliteal cyst. He has no redness or severe pain. What is the best management?
A 27-year-old man presents with periumbilical pain that migr…
A 27-year-old man presents with periumbilical pain that migrated to the right lower quadrant with anorexia and low-grade fever. Examination reveals rebound tenderness at McBurney point. What is the best next diagnostic test?
A 38-year-old man with newly diagnosed hepatitis C virus inf…
A 38-year-old man with newly diagnosed hepatitis C virus infection asks about alcohol use. What should you recommend?
A 24-year-old man has unilateral testicular pain with epidid…
A 24-year-old man has unilateral testicular pain with epididymal tenderness and swelling. He is sexually active with new partners. What is the most appropriate initial therapy?