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A 24 year old obese female presents to the office for evaluation of hypertension. She indicates she recently has been having headaches and asked the nurse at work to check her blood pressure which was 145/92. You review her chart and note that the last two readings were 145/92 and 148/90. Today she presents and her blood pressure is 144/92. The remainder of her vital signs and exam are normal. She indicates that she was recently married and they are trying to start a family, but thought perhaps all the recent changes have been too stressful and increased her blood pressure. What are your recommendations for her?

Which of the following is a true statement regarding benign prostatic hypertrophy?

Tara is a 52 year old woman that presents to your office with bilateral weakness that started in her legs. The onset was rapid and followed with pain, numbness, and tingling. At first she thought her legs were asleep, but the feeling persisted.  When you ask about other symptoms, she mentions before the weakness started she had a fever, cough, and sore throat, with some mild nausea. During your physical exam you note absent reflexes, with sensation still intact, and strength 3/5 in legs bilaterally with 5/5 in arms. What is you leading diagnosis?  

A 47 year old overweight female with type 2 diabetes presents to the office with right upper abdominal pain.   She has had it before but it went away.  This time it has been going on for about 4 hours.  She notes the pain is worse when she eats fried foods. She denies fever, diarrhea, constipation or change in bowel habits.  On exam, she has a positive Murhphy’s sign. Which test is considered most sensitive for confirming her diagnosis?

Debbie is a 35 year old female that presents to the clinic with weakness and numbness of the left arm which started about 2 weeks ago. When discussing her review of systems, she also notes that about 2 months ago she had an episode of diplopia which lasted about 24-36 hours about 4 months ago. She says something similar happened about a year ago and lasted for several weeks and is worried this could be a stroke. Based on this presentation, what is the most likely diagnosis and most likely treatment?   

A 36 year old African American male presents to the office for routine follow-up for hypertension. He reports changes to his diet and is taking his HCTZ 25 mg daily. His blood pressure is 155/87. What is your recommendation for him today?

A 73 year old male presents to the office for follow-up to his systolic CHF. You are explaining to his family that he has New York Heart Association stage III heart disease? What is the most accurate list of medications that he should be taken?

A 37 year old female presents to the office for evaluation. She reports feelings of hopelesness, depressed mood, decreased appetite and sleep. Her employer indicated that she needed to get help because she is not completing her tasks at work and has been calling in sick too much. She feels fatigued and has trouble concentrating. She reports that she has been feeling this way for the last 4 weeks. She did not seek help because 2 months ago she was feeling great. She went out gambling with her friends, participated in a group cocaine party and staying up all night. What is her likely diagnosis and treatment plan?

Which of the following is considered a clinical red flag for a patient who presents with back pain?

A 23 year old male presents to the office complaining of bloody stool. He reports that symptoms started about 1 week ago. He has crampy abdominal pain throughout the day. He denies fever, chills, nausea or vomiting. He reports that this is the 3rd time he has had these symptoms in the past 6 months. He denies constipation. He has not seen any relationship with his diarrhea to the food that he eats. He is sexually active with females only and has never had anal sex. On DRE you note occult blood and diffuse tenderness in the lower abdomen. You have completed baseline labs with CBC/CMP, ESR and CRP. You suspect that he has inflammatory bowel disease, what are your next steps in evaluation?