A 44 year old male presents with severe heartburn. Pain generally occurs after eating a large meal and is usually alleviated by vomiting. On examination, you note pain in the right upper quadrant and the patient also reports pain with inspiration. Based upon these findings, which of the following tests would be the most affective in confirming the patient’s most likely condition?

Spontaneous passage of a renal stone is highly likely in which patient? 

A 42 year old female presents with a chief complaint of abdominal pain for the last 2-3 months. Pain is intermittent and is generally located in the right upper quadrant. Pain seems to last for approximately 20 minutes and is generally exacerbated by eating. Which of the following signs is most likely to be found on physical exam? 

A patient has nausea, vomiting and symptoms suggestive of renal colic. A urinalysis is obtained which shows hematuria but is otherwise unremarkable. Imaging shows a stone in the ureter which are less than 1 mm in diameter. What will the primary provider do initially to manage this patient?

In initial management of the patient with a renal stone, in addition to increased hydration and adequate pain management, what should be considered?

Pain and limping in a child’s leg of insidious onset may be indicative of what?

A 23 year old male with a history of Marfan Syndrome presents with sudden onset of shortness of breath and chest pain. On exam, you notice slightly diminished lung sounds. A chest x-ray was ordered (see below). Based upon this, what is your diagnosis and plan?  

Which of the following is the most common site of nose bleeds?

A 62 year old truck driver presents to your clinic complaining of worsening lower back pain. Pain is accompanied by numbness in perineum and describes pain as “sharp and burning.” Pain seems to be worse in the left buttock. Pain starts in the mid-buttock and radiates to the left leg as well as down the lateral aspect of the leg toward the dorsum of foot. Patellar DTR are 1+ on the left and 2 + on right. The pedal, posterior tibialis are equal in both lower extremities. Which of the following is the most appropriate next step?

Which of the following is NOT one of the criteria of the Ottowa knee rules predicting the need to obtain knee radiographs?