A patient presents with a circular, erythematous, scaly lesion with central clearing on the forearm. Which diagnosis is most likely?

A 66-year-old woman presents with a three-week history of right-sided temporal headache, jaw pain when chewing, and new-onset blurred vision in her right eye. She also reports low-grade fever and fatigue. She has a history of hypertension and is being treated for breast cancer.  On examination, the right temporal artery is tender, thickened, and nodular. Which aspect of this presentation requires the most urgent management?

A provider is conducting a focused respiratory history on a 58-year-old male with progressive dyspnea. The provider suspects the patient may be experiencing orthopnea. Which of the following questions would best elicit this symptom?

A 24-year-old woman presents with a 2-week history of RLQ pain, low-grade fever, diarrhea, and a 10-pound unintentional weight loss over 3 months. She has no known GI history. On exam you note RLQ tenderness, a palpable RLQ mass, and perianal skin tags with a small draining fistula. Based on the physical examination findings, which of the following best explains why this patient’s presentation is NOT consistent with ulcerative colitis?

A pregnant patient in the third trimester presents with intensely pruritic papules and plaques on the abdomen. Which condition is most consistent with this presentation?

A 67-year-old male with a history of hypertension, type 2 diabetes, and osteoarthritis presents to the clinic reporting bilateral lower extremity swelling that began approximately six weeks ago. He states the swelling is worse at the end of the day and improves somewhat overnight with leg elevation. He denies dyspnea, orthopnea, chest pain, or paroxysmal nocturnal dyspnea. On examination, bilateral 2+ pitting edema is present to the mid-calf symmetrically. The skin is warm, without erythema, hyperpigmentation, or ulceration. Lung fields are clear to auscultation bilaterally. His current medication list is as follows: metformin 1000 mg twice daily, atorvastatin 40 mg nightly, omeprazole 20 mg daily, ibuprofen 400 mg as needed, and amlodipine 10 mg daily. Which of the following medications is most likely responsible for this patient’s bilateral lower extremity edema?

A provider is conducting a focused respiratory history on a patient presenting with dyspnea. Which question best assesses the severity of the patient’s shortness of breath?

A 2-year-old female is brought in for sudden-onset respiratory distress that began during playtime. She is afebrile, tachypneic, and has mild intercostal retractions. Breath sounds are diminished over the right lower lobe with wheezing heard only on the right side. The left lung is clear. What is the provider’s greatest clinical concern?

A 32-year-old woman presents with 12 hours of periumbilical pain that has migrated to the RLQ. She has anorexia, low-grade fever, and nausea. You flex her right hip and knee to 90 degrees and internally rotate the leg. She reports increased RLQ pain. This finding is consistent with:

A provider auscultates a scratchy, grating sound that occupies both systole and diastole, heard most clearly just to the left of the sternum at the third and fourth intercostal spaces. The patient reports sharp chest pain that worsens when lying flat and improves when sitting up and leaning forward. Which extra heart sound is most consistent with this clinical presentation?