A 32 year old male comes to the clinic complaining of “coughing up blood” and significant sweating during the night. He has no history of respiratory or cardiac problems. Vital signs are pulse 76, blood pressure 140/74, temperature 99F. Which diagnostic studies should be ordered first?

Factors for emerging infectious diseases include all the following EXCEPT:

The nurse practitioner’s physical exam on a 21 year old college student is as follows: disheveled appearance, 5-lb weight loss since last visit 2 months ago, pulse strong and regular at 128, +4 deep tendon reflexes (DTRs), pupillary dilation, psychomotor agitation, chest pain with his EKG showing premature ventricular contractions (PVCs), nasal mucosa erythematous and ulcerated. He has developed avoidance of family and dangerous behaviors with sexual impulsivity, decreased appetite, insomnia and he is failing two classes. The NP suspects drug use of:

Jonathan is a 23 year old male, who comes to your clinic today with complaints of a sore throat. He complains of difficulty swallowing and has some mouth pain. On examination, you note that his mouth, tongue, and pharynx are covered with a white curdlike plaque that is very difficult to remove and it has a red surface in areas that it has been removed. What action would you recommend at this time?

A mother brings her 17 year-old son to the clinic because she is concerned over some of his behavior for the past 6 months. She reports that he is acting more secretive and talks about a new friend that only he can see. While the mother is talking, her son is staring off into the distance and has disorganized speech. nurse practitioner considers that he may be suffering from:

John comes to the clinic today with a cutaneous lesion that began as vesicles and evolved into papules on his arms. The lesions are linear in nature about 3 to 5 mm long. You suspect:

Mr. James, A 65 year old Caucasian male presents to your office for follow-up on hypertension. You know that his wife died 3 years ago. He states “I’m just so tired…sometimes I think of just ending it all…I miss my wife so much!”. After determining that Mr. Jones does not have a specific plan, you determine that he meets the diagnostic criteria for major depression. What would be your next management steps?

A patient comes to your office with a history of 2 days of fever of 103.4 and a macular-papular rash that began today on her face. You suspect that she has measles. What is the name of the oral lesions on her buccal mucosa?

The U.S. Preventive Services Task Force (USPSTF) recommends screening children and adolescents 12 to 18 years of age for major depressive disorders. Which of the following screening tools would you use to screen the children?

For an adult with Lyme disease, the treatment of choice for erythema migrans (EM) rashes, myalgias, and arthralgias is: