A 58-year-old female with a history of diabetes type 2, hyp…

 A 58-year-old female with a history of diabetes type 2, hypertension and high cholesterol presents to your office for follow-up visit. She reports that overall, she is feeling well. Her blood sugars have been controlled, and she denies any hypoglycemic events.  On PE, her blood pressure is 155/92, HR is 76, RR 16, O2 Sat is 100% on RA. Her labs show decreased GFR of 55 with proteinuria and her A1c is 6.2. She currently takes Glucophage 500mg twice a day, HCTZ 25mg daily and Atorvastatin 80mg.  What would your next step in management of this patient be?

A 42-year-old male with no medical history presents to the o…

A 42-year-old male with no medical history presents to the office complaining of pain in his left great toe starting 2 days ago. He indicates that he is unable to walk and is in a wheelchair. He denies any trauma to the toe or foot. The toe is red, swollen, exquisitely tender and he is unable to extend it. You review his chart and note that he has been married for 20 years, works as a auto salesman and drinks a 6 pack of beer daily. He is allergic to ibuprofen. Select the best treatment from the options listed below.