The goal of the management of GERD includes all of the following except:

*Megan presents with RUQ abdominal pain and she has a positive Murphy’s sign. You are suspecting that Megan is experiencing issues with her gall bladder.  What radiological test would you initially order?

Jessie, age 29, experiences photophobia about 20 minutes before experiencing severe headaches.  The headaches are unilateral and throbbing along with nausea. How would you describe her headache?Jessie, age 29, sees flashing lights 20 minutes before experiencing severe headaches in addition to nausea. How would you describe her headache?

Mr. Resch, 55, was diagnosed with hyperlipidemia six months ago.  He declined medications & has been exercising regularly and has changed to a low fat diet.  Results of his fasting lipid panel last week are: Total cholesterol – 202, LDL – 176, HDL 33, and VLDL 22. His 10 year risk of major CV event is 12.1%. Which of the following would be the most appropriate class of medication to prescribe for Mr. Resch’s hyperlipidemia?

MJ, 55y/o, started Atorvastatin about 1 mo ago.  She has a f/u today in clinic and she reports that she is having muscle pain and darker urine since starting the drug. What would you do FIRST?

*Alan, an 18 year old male, has an elevated B/P reading while in the office for a shoulder injury. B/P is 144/92. Mom and dad both have hypertension. Your next action is to:

Karl Jones, a 60-year-old male presents to your clinic with a chief complaint of an enlarged scrotum. During your exam you use a penlight to transilluminate the scrotum.  You diagnose a hydrocele based on which of the following findings.

Isabella is a 32 year old female that presents to your clinic with complaints of  a 4 week history of weight loss, nausea, fatigue, diarrhea. Her B/P today is 98/64 and her random finger stick blood sugar is 55.  On physical examination she appears dehydrated and when assessing her skin and mucus membranes you notice increased skin pigmentation. You suspect: 

CB is a 33-year-old male who comes to your clinic for the first time. He states he was diagnosed with asthma when he was 5 years old. He tells you he has symptoms daily and has to use his SABA inhaler daily. He has exacerbations 3-4 times a week, night time symptoms 2 times a week. You decide to modify his asthma plan. Which of the following would you include?

Your patient presents with 3 day history of low back pain. The history is positive for strain while lifting 3 days ago, but no other worrisome or symptoms.  The physical exam is normal except for only pain to the right lateral L4-L5 areas with flexion and extension and slight limp with heel-to-toe gait. Your plan today includes: