Mr. B is a 50-year-old man presenting with a 6-month history of progressively worsening joint pain, stiffness, and swelling. He reports morning stiffness lasting more than an hour, affecting both hands, wrists, and knees. He also complains of fatigue and low-grade fevers occasionally. There is no significant family history of autoimmune diseases. Mr. B works as a computer programmer and has noticed difficulty with typing due to joint pain in his fingers. Clinical Examination: On examination, Mr. B appears fatigued but is alert and oriented. There is bilateral tenderness, warmth, and swelling of the proximal interphalangeal joints, metacarpophalangeal joints, and wrists. He has limited range of motion in these joints due to pain. Cardiovascular and respiratory examinations are unremarkable. Laboratory Findings: Complete blood count: Normal. Erythrocyte sedimentation rate (ESR): Elevated. C-reactive protein (CRP): Elevated. Rheumatoid factor (RF): Positive. Anti-cyclic citrullinated peptide (anti-CCP) antibodies: Positive. Joint aspiration: Synovial fluid analysis shows inflammatory changes. What is the most likely diagnosis based on Mr. B’s clinical presentation and laboratory findings? 

In the early-adulthood age bracket, what is the leading cause of death?

When infants are uncertain about whether their caregivers will be responsive when needed, they may develop what type of attachment issue?

Which is TRUE in the event that off-duty paramedics provide advanced life-support interventions, such as intubating a cardiac arrest patient, at an emergency scene?

A 70 year old patient presents to your office with questions related to the flu vaccine and contracting Guillain-Barre’ syndrome. You provide reassurance and education to the patient that the risk is rare and they should call to be seen if they experience one of the following common symptoms:

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An adolescent patient comes to the primary care provider because of a swollen right axillary lymph node which is warm, tender, and rapidly enlarging. Which initial action will the provider take?

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The following medication classes are newly indicated as per the American Heart Association guidelines for management of HFpEF except:

A 26 month old female here for evaluation. No eye contact, she would not look at people when called. Repetitive behaviors. (doing a simple puzzle and then dumping it and starting the puzzle over again, hand flapping) No interaction with other children at daycare. Unable to use 2-word phrase. Unable to follow two step commands. On PE – Bouncing on her mom’s lap with hand What would NOT be included on your differential: