A 18 year old female presents to the office complaining of diffuse abdominal pain, fever, nausea and vomiting.  On exam you note a fever of 101.6 and heart rate of 116, but the remainder of her vital signs are normal. On examination, she has guarding and rebound tenderness. She has abdominal pain when passively extending her thigh lying on her side with knees extended and with active flexion of her thigh. What dose she have and what are your recommendations?

A 24 year old obese female presents to the office for evaluation of hypertension. She indicates she recently has been having headaches and asked the nurse at work to check her blood pressure which was 145/92. You review her chart and note that the last two readings were 145/92 and 148/90. Today she presents and her blood pressure is 144/92. The remainder of her vital signs and exam are normal. She indicates that she was recently married and they are trying to start a family, but thought perhaps all the recent changes have been too stressful and increased her blood pressure. What are your recommendations for her?

Patients who have bipolar disorder should not be treated with antidepressants without a mood stabilizer because it may exacerbate their mania symptoms. 

A 48 year old male presents to the office for a physical. He reports no complaints. His lab work is all normal except for an LDL of 187 and a ASCVD of 13%. What are your recommendations for this patient?

A 47 year old overweight female with type 2 diabetes presents to the office with right upper abdominal pain.   She has had it before but it went away.  This time it has been going on for about 4 hours.  She notes the pain is worse when she eats fried foods. She denies fever, diarrhea, constipation or change in bowel habits.  On exam, she has a positive Murhphy’s sign. Which test is considered most sensitive for confirming her diagnosis?

Rheumatoid arthritis is a joint disease that can affect the skin, eyes, lung, heart and vascular system:

A 35 year old male presents to the office for complaints of a headache. He describes the headaches as one sided, pulsating and lasting for about 1-2 hours. He notes that his eye sometimes waters with the headache. He denies nausea, vomiting, fever, chills, photophobia or phonophobia. What is considered first line treatment for this headache?

A 31 year old male presents to your office for a follow-up visit. He was seen 2 weeks ago for fatigue and a sore throat. He indicates that he has not gotten better since that time . He still has a fever and the fatigue has gotten worse. He has been gargling with salt water and using cepachol lozenges. You checked a rapid strep test and it was negative. He indicates that he is sexually active with men and has oral and anal sex. What additional testing(s) would be most appropriate for him at this time?

Which of the following is considered a clinical red flag for a patient who presents with back pain?

A 28 year old female is diagnosed with a urinary tract infection that is most likely caused by a gram-negative organism. Which finding on UA would support this diagnosis?