A 26 year old male presents to the office for complaints of knee pain. He indicates that he has been running 4-5 miles daily for the past several months. He denies trauma/injury to the knee. He just noticed that it is achy and mildly swollen. On exam, you note tenderness over the patellar. The lachman, mcmurray, valgus/varus testing are all within normal limits. He has a negative anterior and posterior drawer sign. There is mild swelling around the patellar but no warmth or erythema. What is your recommendation for him?

A 59 year old female with history of hypertenson, diabetes and high cholesterol presents to the office for substernal chest pain radiating to her left arm that started 30 minutes ago and continues. What is the most appropriate action?

A 19 year old female presents to the office for asthma follow-up. She notes that she has been using her low dose Symbicort (budesonide/formoterol) inhaler daily but still feels short of breath at least once a day. What do you recommend?

A 32 year old female presents to the office for vision loss in one eye for one day but has resolved. She also notes facial weakness, numbness and dysarthia that followed. As you review her chart, you note that she was seen 2 months ago for numbness and tingling in the left side of her body which has since resolved. You are concerned about multiple sclerosis (MS). What testing would be suggestive of MS?

A 16 year old patient who presents with a rash over his trunk and back. He notes there are area of both hyperpigmentation and hypopigmentation. He plays soccer daily during gym class and is also on the soccer team at school. He denies pain, itching or discharge. On exam, the rash is flat and consists of areas of hypo/hyperpigmentation on the trunk. What is the likely cause?

A 23 year old male presents to the office for acne treatment. He indicates that he has had acne all of his life and has used benzoyl peroxide in the past but has not tried anything else. On exam, he has open and closed comedones, papules and postules. What would you recommend for him? 

A 62 yo female who presents with pain in her hands and fingers that is getting worse.  She denies any trauma or other musculoskeletal complaints.  She is overweight (BMI 30.5) and has hypertension which is controlled by medication.  On exam you observe bilateral Heberden and Bouchard nodes.  This finding would most likely by seen in?

A 65 year old female presents with a past medical history of hypertension and hyperlipidmeia presents to the office for complaints of knee pain for the past several months. She denies recent trauma or injury to the knee. She notes that it is painful to walk more than 1/2 mile and she is getting fatigued much sooner. She notes some swelling in the knee as well. On exam, you note that she has mild swelling over the medial joint with crepitus. There is no warmth or redness. She has good range of motion, but it is painful for her to internally rotate the knee. You advise her the best treatment for her right now is:

A 48 year old female presents to the office for fever, chills, cough and congestion for the past 2 weeks. She notes that she feels short of breath and also has a decreased appetite. She has a PMH of hypertension, diabetes, a recent broken leg and takes losartan and glucophage. She is allergic to penicillin and clarithromycin medications.  A CXR shows a right lower lobe consolidation. How would you treat her?

A 62 year old male complains of chest pain that occured while shoveling snow.  The pain stopped after 5 minutes of rest.  In the office an EKG and vital signs are normal. His LDL is 169 and HDL is 23. His vital signs show the following: BP 155/90, HR 92, RR 12, O2 Sat 100%. Based on this information, what medications would you make sure that he was taking before leaving your office?