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A 32 year old female presents to the office for complaints of dysuria, incomplete bladder emptying and blood in urine. On exam you note a fever of 101.4 and CVA tenderness. The remainder of her vitals and exam are stable. She is allergic to sulfa. Her urine is positive for blood, +leukocytes and +nitrates. How would you treat her?

A 26 year old male presents to the office for complaints of knee pain. He indicates that he has been running 4-5 miles daily for the past several months. He denies trauma/injury to the knee. He just noticed that it is achy and mildly swollen. On exam, you note tenderness over the patellar. The lachman, mcmurray, valgus/varus testing are all within normal limits. He has a negative anterior and posterior drawer sign. There is mild swelling around the patellar but no warmth or erythema. What is your recommendation for him?

As part of the monitoring for a patient being treated for Rheumatoid Arthritis with methotrexate, which of the following should be considered?

A 55 year old male presents to the office for concerns about chest pain which has been going for the past 6 months. He reports that it occurs when he is playing on a recreational basketball team. He notes that when he rests, the pain goes away. He has a history of hypertension and hyperlidipemia and takes valsartan, HCTZ and rosuvastatin. On exam today, his vital signs show BP 149/90. You are planning to order a stress test for him, but want to treat his discomfort. What medication would you use for him?

Which of the following is true regarding Asthma?

A 22 year old female presents to the office for vaginal discharge. She is sexually active and has had 4 partners in the last 3 months and 6 partners in the last year. She has an IUD and uses condoms occasionally. She reports the discharge has a foul odor to it and is yellowish. She complains of vaginal irritation and some discomfort with urination. On wet mount she has a positive whiff test, with motile flagella and no clue cells. What is your treatment plan for this patient?

A 35 year old female presents to the office complaining of lower back pain for the past 2 weeks. She indicates the pain often 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 her diagnosis and the appropriate treatment?

A 50 year old male who presents with heart burn for the past 3 months daily is diagnosed with gastroesophageal reflux disease (GERD).  Which is first line treatment for this patient?

Which of the following is a characteristic of mania?

A 53 year old African American male presents to your office for follow-up. He was diagnosed with hypertension 3 months ago and is currently taking HCTZ 25 mg daily. He reports that he is feeling well and denies any complaints of lower extremity swelling, chest pain, shortness of breath or headaches. His physical exam reveals the following: BP: 150/87, HR: 73, RR 14, Temp 98.6, O2 Sat 100% and normal ECG. His PE is normal. What is the next best step in management of this patient?