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?

  A 37 year old African American male presents to the office for a routine physical. This is the first time he has been to the doctor in 7 years.  He has no complaints and overall reports that he is doing well.  On exam, you note the following: T: 98.7, HR 72, RR 14, BP 145/88, BMI 27. The remainder of his exam is normal. What is the next best step?

A 45 year old female presents to your office with complaints of diarrhea, weight loss and sweating for the past 3 months. Her vital signs are as follows:  HR 115, BP 119/82., RR 12, SPO2 99% RA you note that her thyroid is enlarged.  You would like to evaluate her for a thyroid condition.  You order a TSH which is abnormal and then you order a Free T3 & T4.   Here are your lab results: TSH 0.2 mIU/L (normal  0.4-6 miU/L) Free T4 8.6 ng/dL (normal 0.7-2.0 ng/dl) Free T3 4.3 pg/dL (normal 2.3-4.2 pg/dL) Based on the above, the next logical step would be to order which of the following?