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            You are the clinician in a primary care clinic….

            You are the clinician in a primary care clinic. A 5-year-old child presents with ear pain, mild fever, and fussiness over the past 2 days. The parent reports that the child has been tugging at the affected ear and seems more irritable than usual. On examination, the external ear appears normal. You decide to perform a pneumatic otoscopic examination to further evaluate the ear. Which of the following is the primary purpose of a pneumatic otoscopic examination?

             You are the clinician in a primary care clinic….

             You are the clinician in a primary care clinic. A 52-year-old patient presents with a daily sensation of heaviness in the lower legs that has been gradually worsening over the past several months. On physical examination, you note visible varicose veins, mild pitting edema, and a dusky discoloration of both ankles and feet. The patient denies recent trauma, fever, or acute pain. Which of the following is the most likely cause of these symptoms?

You are the clinician at the student-health center at a larg…

You are the clinician at the student-health center at a large university. Jack, a 20-year-old male college student with a history of chronic migraines, has been experiencing a headache and vomiting for about 24 hours. His roommate and friends have not been ill. He and his roommate just returned a day ago, from a 3 day hiking trip to Oregon with his dog. His roommate reports that he brought Jack to the clinic because, “he isn’t acting right this morning.”  Your exam reveals the following: altered mental status, headache, and vomiting. While having Jack lie flat on his back, you flex the thigh so that it is at a right angle to the trunk (see image below). You note severe hamstring stiffness causing an inability to straighten the leg due to severe pain. Which of the following is the most likely differential diagnosis?