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A 32 year old obese female patient taking hormone replacement therapy presents with severe abdominal pain with acute onset over the past 24 hours. Upon physical exam patient has a positive Murphy’s sign.  What is the likely diagnosis?

A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?

A 56 year-old female with a history of allergic rhinitis presents to the NP’s clinic with a stuffy nose. She has been using the nasal decongestant Afrin for the last month, and now she is unable to stop taking it without having significant difficulty breathing through the nose. What is her probable diagnosis? 

A 26 year old female patient presents to your clinic with chief complaint of abdominal pain.  She complains of nausea and vomiting, fever and anorexia.  She states her abdominal pain started approximately 2 hours ago.  Upon physical exam the patient complains of pain upon performing palpation at McBurney’s point.  Of the following, what is the differential diagnosis requiring highest priority to rule out?

An 18-year-old female reports fever and headache for the last two days. She has been in bed for two days. Her fever is currently 102° F. She presents today because her throbbing headache is getting worse despite ibuprofen this AM. She denies nausea, vomiting, dizziness. She has h/o migraine with aura and sickle cell trait. She did not receive the influenza vaccine this year. Her contacts are not ill. On exam, she has a positive Brudinski and Kerning’s sign. What’s the most likely diagnosis?

A 50 year old male patient presents to your urgent care clinic with a bloody nose.  He tells you that he has gotten bloody noses before occasionally, especially when his allergies are bad, but that he can always get them to stop by applying pressure.  He has not been able to get this one to stop, so he is asking for your help.  What should you try first?

Which of the following adults should receive a Recombinant Zoster Vaccine (RZV) (Shingrix) vaccine?

Which of the following is indicated in the treatment of Meniere’s disease? 

A 45-year-old man with a PMH of Crohn’s presents with a recurring rash that has lasted several years. He states that the rash consists of lesions that are scaly and silvery in color. The skin lesions occur on his elbows, knees, and gluteal cleft frequently and come and go over several months with no apparent trigger. He denies fever, chills, nausea, and sweating. The patient’s temperature = 98.5°F, HR = 80, RR = 18, and BP = 110/70. Physical exam reveals a silver, scaly plaque over his elbows and knees (picture shown below). He has punctate bleeding when the outer scale is removed from a portion of the lesion. What is the most likely diagnosis? derm3.jpg

A 49-year-old male patient presents to the emergency room after escaping from a fire at the local food store. He comes in with extensive burns to both feet and covering approximately 25% of the remainder of his body. The patient is stabilized and flown to the nearest burn center. The burns on his feet are described as including the subcutaneous tissue. There is no muscle, tendon, or bone exposed. What is the correct classification of the severity of this burn?