A 50 year old male presents with complaint of severe pain in the right big toe that started a few hours ago. He denies fever.  On exam there is swelling and erythema of the right big toe. Which of the following can be used to exclude septic arthritis?

You are examining a 67 year old male in the emergency department. On auscultation of the chest you hear a “blowing” S2 that is loudest at the 2nd intercostal space. Which type of murmur is this? 

A patient presents with complaints of green discharge from nasal passages, facial pain, and congestion for 10 days. On exam the patient displays tenderness with palpation over the maxillary sinuses bilaterally with mild swelling noted over the right maxillary sinus area. He has swollen erythemous turbinates bilaterally. The patient has been using flonase nasal spray and taking an over-the-counter decongestant with only mild improvement in symptoms. The patient has a penicillin (PCN) allergy.  What is the most appropriate treatment?

Which of the following medications can cause migraine headache or make migraine headaches more frequent? 

An 18 year old female presents to the urgent care clinic with complaints of throbbing left ear pain that has worsened over the last 3 days. On exam you note a dull appearance with the tympanic membrane bulging. What is the preferred treatment? 

A 35 year old is found to have an acute right lower extremity deep vein thrombosis (DVT) after a 4 hour car ride to visit family. Her only medical history is hypothyroidism. She takes thyroid medication and oral contraceptive pills.  Which of the following interventions is not included in the treatment plan?

Endocarditis is suspected in a patient that presents with general malaise, night sweats, fatigue, exertional dyspnea and fever lasting several weeks. The nurse practitioner orders a series of three blood cultures, CBC, metabolic panel and electrocardiogram. What other diagnostic study is indicated? 

Which two anti-hypertensive medications should not be combined? 

A 19 year old presents to the college’s on campus urgent care clinic with complaints of itching and redness of his eyes. On physical exam you note edema of the eyelids, erythema to the conjunctiva, and yellow discharge from both eyes.   What is the best treatment option for this patient?

A 75 year old presents to the emergency department with complaints of “raising heart and palpitations”. On physical exam you auscultate an irregular rhythm that is tachycardic, and radial pulse is 2+. ECG reveals a rate of 125 without P waves. What is the most likely rhythm?