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A 42-year-old male presents with complaints of sudden, severe, unilateral periorbital pain that he describes as stabbing and excruciating. The episodes last about 60 minutes and have occurred multiple times daily for the past week. He also reports nasal congestion and watery eyes on the affected side. What is the most likely diagnosis?

The examiner notes the following on exam of a 4 year old child:  anterior cervical adenopathy, fever, petichiae in the posterior pharynx, tonsilar exudates, and a history negative for cough.   The examiner diagnoses Group A Beta Hemolytic Strep Tonsillitis.   This is an example of:  

You note the following on visual inspection of the eye of a 50 year old patient.  This finding would lead you to:Pterygium_of_the_eye.jpg

You are examining a diabetic’s feet.  Which instrument would provide you with a way to objectify fine sensation between different examiners?

You are seeing a 25 year old who is 23 weeks gestation.  Which statement below would you prioritize from her history? 

A 6-year-old child is brought to the clinic complaining of severe left ear pain that worsens when the pinna is moved. The child recently went swimming at a local pool. On exam, the external auditory canal is erythematous and swollen with visible purulent discharge. The tympanic membrane is not well visualized. Based on the image provided, which diagnosis is most consistent with these findings? f13-17-9780323761833.jpg

You are seeing a 45 year old patient for a complete physical exam.  They are concerned about a worsening need for reading glasses.  Which chart would you choose to evaluate near vision?  

*Bonus Question* You are seeing a 2 year old whose mother states she has had high fever and mild respiratory illness for the past few days. She brought her in today because she now has this rash “all over” but is “back to her old self.” On exam you note discrete, non-tender adenopathy involving the postauricular chains and this maculopapular rash. roseola.jpg What is your diagnosis?

Loss of immediate and recent memory with retention of remote memory suggests 

You are explaining the results of a Snellen exam to a staff member.  The patient’s results indicated 20/40 in her left eye, 20/100 in her right eye, and 20/30 in both eyes.  How would you explain these findings?