A 26-year-old walks into your family practice with sudden right-sided chest pain and dyspnea. He is tachycardic and hypotensive. Breath sounds are decreased on the right, percussion is hyperresonant, and the trachea is shifted left. What is the best immediate action in the clinic?

A 65-year-old smoker reports coughing up “about a cup” (~200 mL) of blood over the past 24 hours. Vitals are stable. What is the best next step?

A 24-year-old with a family history of familial hypercholesterolemia is in for new patient exam. Which related finding would you anticipate if his LDL has been severely elevated without treatment since early childhood?

A 56-year-old with Diabetes, Hypertension, and a history of Coronary Artery Disease and Peripheral Vascular Disease has an LDL of 181 mg/dl. What would you recommend for cholesterol treatment?

Which physical exam finding is most consistent with an asthma exacerbation?

A 58-year-old reports progressive dyspnea on exertion, fatigue, and one episode of near-syncope while climbing stairs. Exam shows a loud P2, right ventricular heave, jugular venous distention, and peripheral edema. Which diagnosis best fits these findings?

A 62-year-old man with a history of CAD presents with transient monocular vision loss (amaurosis fugax). Carotid duplex reveals 70% stenosis. What is the most appropriate management?

A 59-year-old woman presents with palpitations, dizziness, and fatigue. ECG shows an irregularly irregular rhythm without distinct P waves. What is the most important initial management step?

A 66-year-old with confirmed COPD reports daily exertional dyspnea. He had no exacerbations in the past year and has no history of asthma. Which maintenance medication class is most appropriate to start?

A 32-year-old has a 10-day history of cough after an upper respiratory infection. Afebrile, lungs with scattered rhonchi, and normal oxygen saturation. What is the most appropriate management?