Mr. Hernandez is a 78-year-old man with a history of hypertension who presents for his routine follow-up. He is moderately built and reports that he feels well. His physical exam is unremarkable. Recent labs show a serum creatinine of 1.3 mg/dL, which is slightly above the reference range. His creatinine was 1.0 mg/dL one year ago. Which of the following best explains the clinical significance of this finding in an older adult?

A 52-year-old patient with central obesity, hypertension, impaired fasting glucose, and dyslipidemia meets diagnostic criteria for metabolic syndrome. What is the most important initial goal in managing this condition?

A 49-year-old woman presents with new-onset urinary retention, fecal incontinence, saddle anesthesia, and progressive bilateral lower extremity weakness. On exam, she has decreased anal sphincter tone and diminished patellar reflexes. What is the most appropriate next step in management?

A 25-year-old male presents to the emergency department with right lower quadrant abdominal pain, nausea, and fever. The clinical suspicion for acute appendicitis is high. Which of the following imaging modalities would be least helpful in diagnosing acute appendicitis?

A 25-year-old daycare worker develops watery diarrhea during the winter months. Several children at the daycare have had similar symptoms. Which of the following is the most likely causative agent?

A 38-year-old woman with a history of mitral valve prolapse (MVP) without regurgitation is scheduled for a routine dental extraction. She expresses concern about the risk of infective endocarditis and asks if she needs antibiotics before the procedure. What is the most appropriate response?

Mrs. Johnson is a 62-year-old female with a body mass index (BMI) of 24 and a history of asthma.  She has hypertension that has been under control with hydrochlorothiazide 25 mg PO daily.  Her total cholesterol is 230 g/dl.  How many risk factors for coronary heart disease (CAD)  does she have?

A 32-year-old female presents to the clinic with lower abdominal pain. On physical examination, passive extension of the right hip while the patient lies on their left side elicits pain. This finding suggests irritation of which structure and is most commonly associated with which condition?

This 29 year man just returned from his international business trip to the Philippines.  He spent 1 month exploring the country during this time frame.  He has been experiencing some malaise, a non productive cough and a low grade fever which he thinks is from all of his travels.  You get a Chest xray seen below.  What is your diagnosis?

A 42-year-old female presents with right upper quadrant pain, nausea, and fever. During the physical examination, you palpated her right upper quadrant while asking her to take a deep breath. She suddenly stops inhaling due to pain. This finding is known as: