A provider examines a 3-year-old male who awakened suddenly from sleep with a barking cough, inspiratory stridor, and mild retractions. He is afebrile and alert, without drooling or a toxic appearance. Mom notes he was sick “last week.” Which diagnosis is most consistent with this presentation?

You get a phone call at 1AM and hear a frantic voice on the other end of the line exclaim, “Doc! I think my horse has a broken leg! He won’t place any weight on it.” You attempt to calm Mrs. Picklebottom down and ask her some basic history questions. You gather through the sniffles and sobbing that it appears her beloved Henry became acutely lame in his right hindlimb after being kicked by another horse in the pasture at approximately 6PM. You as an astute veterinarian realize that this could be very serious and ask her to bring the horse in for further evaluation and note a laceration on the lateral aspect of the right hindlimb; you probe the wound and note a sharp piece of bone. You perform radiographs of the right hind metatarsus at the level of the wound. Please characterize the fracture.

A provider is evaluating a 68-year-old male with a 50 pack-year smoking history who presents with a 6-week history of worsening productive cough, 12-pound weight loss, and one episode of hemoptysis. He has no fever. On examination, there is dullness to percussion over the right upper lobe, with locally increased fremitus and a persistent, fixed, high-pitched wheeze heard only over the right upper chest. Breath sounds are decreased bilaterally. Which of the following diagnoses is most consistent with the complete constellation of findings? 

A 52-year-old obese woman presents with intermittent heartburn, regurgitation, and a chronic cough. She works as a warehouse loader and has had two pregnancies. Her abdominal exam is unremarkable. Which combination of findings from her history most increases her risk for hiatal hernia?

You are evaluating a 17 year old male with faintly erythematous macular lesions with fine scaling. His hands and feet are clear, only his trunk and extremities show skin changes. The rash on his trunk could be described as a Christmas tree pattern. What additional skin change is associated with the above skin disorder? 

[[[INSERT BIRMINGHAM PHOTO]]] This photograph captured:

A 54-year-old female presents to the clinic reporting three days of left lower leg swelling and achiness. She underwent a right total hip replacement six weeks ago and was relatively immobile for the first two weeks of recovery. She denies fever, chest pain, or shortness of breath. On examination, the left calf is visibly larger than the right. When the provider presses firmly over the left medial malleolus for five seconds and releases, a depression of approximately 4 millimeters is produced that resolves within 10 to 15 seconds and leaves no visible distortion of the surrounding tissue. How would you accurately document this finding?

With no tether, an astronaut is in space, floating away from her spaceship toward certain death. If she is holding a large wrench, how can she save herself?

A provider is palpating the chest wall of a 45-year-old male who was involved in a motor vehicle accident two hours ago. On palpation over the left lateral chest wall, the provider detects a crackling, bubbly sensation beneath the skin. The patient denies shortness of breath and oxygen saturation is 96%. What is the most appropriate interpretation of this finding?

A provider observes a diffuse eruption involving the trunk and proximal extremities with relative sparing of the face and distal limbs. Which diagnosis should be highest on the differential diagnosis based on the distribution pattern?