A 48-year-old woman presents to her primary care provider with complaints of persistent ringing in her ears (tinnitus) for the past six months. She reports that the tinnitus is more noticeable in quiet environments and sometimes interferes with her ability to concentrate. The provider takes a detailed history and conducts a physical examination to identify potential causes of her tinnitus. Which of the following is not a recognized cause of tinnitus in this patient?

a 62-year-old woman presents to the clinic with complaints of brief episodes of dizziness and a sensation of spinning that occurs when she turns her head or gets out of bed. She notes that these episodes last for about 30 seconds and are accompanied by nausea but not by any hearing loss. The NP suspects benign paroxysmal positional vertical (BPPV) and decides to perform a clinical test to confirm the diagnosis. Which of the following tests is most used to diagnose BPPV?

A 45-year-old woman presents to the clinic with complaints of progressive hearing loss in her right ear over the past six months. She also reports experiencing occasional dizziness and a persistent ringing in her right. An examination, the provider notes abnormal ear exam but suspects an issue with the inner ear. An MRI is ordered and the results reveal a mass on the right vestibulocochlear nerve. What is the most likely diagnosis for this patient based on her symptoms and MRI results?

A 7-year-old boy presents to the clinic with his mother complaining of increased difficulty hearing in his right ear and foul-smelling discharge coming from that ear. He has a history of recurrent ear infections over the past year. Upon examination, you observed that the right tympanic membrane is retracted and there is a visible mass in the middle of the ear space. What is the most likely diagnosis for this child’s condition?

A 29-year-old woman presents to the emergency department with complaints of a severe headache that began about an hour ago. She describes the headache as throbbing and located predominantly on the right side of her head. Before the headache started, she experienced visual disturbances, including flashing lights, and a temporary loss of vision in her right eye. She has a history of migraines but stated this episode felt different from her usual migraines. What is the most likely diagnosis for this patient?

A 68-year-old woman returns to the clinic for follow-up after she was seen the day before for a painful, vesicular rash to the left side of her forehead and her left temple. She has never had this type of rash before anywhere on her body. On today’s visit, she reports left eye irritation, increased tearing, and light sensitivity. On a fluorescein dye examination, a dendritic uptake pattern is noted next to a 1 mm diameter ulceration. What pathogen is most likely responsible for these findings?

A 19-year-old woman presents to her primary care provider with intense itching and a rash between her fingers, on her wrists, and around her waist. She reports that her symptoms began 2 weeks ago and have been progressively worsening. Upon examination, the provider notes small burrows and papules consistent with scabies. The provider decides to prescribe a topical treatment. How is Permethrin applied for scabies?

A 7-year-old boy presents to the clinic with his mother complaining of increased difficulty hearing in his right ear and foul-smelling discharge coming from that ear. He has a history of recurrent ear infections over the past year. Upon examination, you observed that the right tympanic membrane is retracted and there is a visible mass in the middle of the ear space. What is the most likely diagnosis for this child’s condition?

A 45 year old woman with a history of Hashimoto’s thyroiditis presents for routine follow up. She reports feeling well but has gained 10 lbs over the last three months. For laboratory tests show elevated TSH and decreased free T4. What is the most appropriate management for this patient?

A 58-year-old woman with no significant past medical history presents with a 2-month history of recurrent brief episodes of vertigo. The episodes are usually provoked by particular head movements and occur a few times each day. They occur when the patient is getting up from or rolling over in bed. She denies any hearing loss, tinnitus, nausea, vomiting, fever, vision changes, or other neurologic complaints. The woman also denies any recent upper respiratory infection or trauma. Physical examination is within normal limits. The Dix-Hallpike maneuver provokes nystagmus and vertigo. What is the most likely diagnosis?