A 59-year-old woman presents with palpitations, dizziness, and fatigue. ECG shows an irregularly irregular rhythm without distinct P waves. What is the most important initial management step?

A 62-year-old man with a history of CABG presents with occasional calf discomfort when walking long distances, which resolves with rest. He states he is still able to complete daily activities, including grocery shopping and yard work, without significant limitation. Ankle-brachial index (ABI) is 0.75. What is the most appropriate next step in management?

A 67-year-old with long-standing hypertension is uncontrolled on an ARB alone. Which combination is most appropriate?

A 5-month-old infant is brought to clinic in January with nasal congestion, cough, and increased fussiness. On exam, the infant has tachypnea, diffuse wheezing, and mild intercostal retractions. Oxygen saturation is 95% on room air, and oral intake is adequate. Which of the following is the most likely diagnosis?

A 55-year-old man with hypertension presents for evaluation. Carotid bruit is noted on exam. What is the best initial diagnostic test?

Which physical exam finding is most consistent with an asthma exacerbation?

Which of the following is a known risk factor for asthma-related mortality?

A 70-year-old presents with cough and fever. Chest radiography confirms pneumonia. His oxygen saturation is 91% on room air. He can take oral medications and has no major comorbidities. What is the best next step?

A 10-year-old girl presents with recurrent nighttime cough and shortness of breath when playing soccer. Spirometry shows an FEV₁ increase of 15% after bronchodilator therapy. Which of the following is the most appropriate diagnosis?

A 58-year-old with cough and mild dyspnea presents to clinic. Which initial assessment action is most critical to determine need for urgent referral?