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A 32 year old male presents to the office for left upper abdominal pain. He reports it started this morning when he awoke. He complains of nausea, vomiting, and decreased appetite. He has a history of alcohol abuse.  You suspect he has pancreatitis and explain that his treatment will include

A 18 year old female presents to the office complaining of diffuse abdominal pain, fever, nausea and vomiting.  On exam you note a fever of 101.6 and heart rate of 116, but the remainder of her vital signs are normal. On examination, she has guarding and rebound tenderness. She has abdominal pain when passively extending her thigh lying on her side with knees extended and with active flexion of her thigh. What dose she have and what are your recommendations?

Lisa is a 22 year old female that smokes 2 PPD with a 5-pack per year history of cigarette smoking. She saw you 3 days ago and had productive yellow sputum, cough, SOB, and low grade fever. CXR confirmed RLL infiltrate and she was diagnosed with community acquired pneumonia (CAP) and she was started on Azithromyacin and guafanesin. On today’s follow up visit she denies fever, says cough had improved and feels less SOB. Initially, she had rhonchi on exam and today you note some inspiratory crackles and tactile fremitus. What is the next step in your plan of care?

Side effects of SSRI’s include the following: nausea, vomiting, GI upset and sexual dysfunction.

A 19 year old female presents to the office for complaints of shortness of breath and wheezing. She indicates that she ishavign daily symptoms has awoken 3 times in the last week due to coughing.  She denies smoking and allergy symptoms. She has missed several days of work because she has not been feeling well. In the office she has wheezing and coughing, but otherwise everything else is normal on exam. She has normal vital signs and denies congestion, runny nose, fever/chills. What medication is the preferred choice for her?

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?