A 60-year-old woman with long-standing rheumatoid arthritis presents with increased joint pain, swelling, and morning stiffness. She has been on methotrexate for two years but reports that her symptoms have worsened over the past few months.What is the next best step in managing this patient?

A 68-year-old woman presents with a 3-week history of severe pain and stiffness in her shoulders, hips, and neck, particularly in the mornings. She mentions that she has trouble combing her hair and getting up from a chair due to the pain. She also reports feeling unusually fatigued. On examination, she has tenderness and decreased range of motion in her shoulder and hip joints bilaterally. There are no joint deformities noted. Her ESR is elevated. She has no significant medical history or family history of autoimmune diseases.What is the most likely diagnosis for this patient?

Which of the following are common symptoms of giant cell arteritis (GCA)?Select all that apply.

A 32-year-old man presents to your clinic after prolonged exposure to freezing temperatures. His fingers appear pale, firm, and have a waxy texture, but he reports minimal pain. What is the initial step in the management of frostbite?

A 56-year-old woman with obesity, hypertension, and type 2 diabetes mellitus (DM2) presents to the clinic for routine follow-up. Her current medications include metformin 1,000 mg twice daily and glimepiride 4 mg daily. Her HbA1c is 8.7%, up from 7.9% three months ago. She has no significant symptoms of hypoglycemia but reports difficulty losing weight despite a healthy diet and regular exercise. Her blood pressure is well-controlled, and her kidney function is normal.What is the next best step in her diabetes management?

A 48-year-old man with atherosclerotic heart disease and type 2 diabetes mellitus (DM2) has been taking metformin 1,000 mg twice daily for the past year. His HbA1c is 9.1%, up from 8.0% three months ago. He is overweight (BMI 31) and has a family history of cardiovascular disease. His blood pressure today’s visit is 136/82 mmHg, and cholesterol levels are well-controlled, and his eGFR >70What is the most appropriate additional medication for this patient?

Which medication class is commonly prescribed to manage Raynaud’s symptoms?

A 35-year-old man presents with a superficial partial-thickness burn on his forearm after spilling hot coffee. The burn is red, painful, and has intact blisters. What is the most appropriate initial management?

A 29-year-old female presents to the clinic with a deep bite wound on her right hand from a cat. The wound appears to be 1 cm in length, with mild swelling and erythema around the site. She denies fever but reports mild pain and tenderness. The patient has no known allergies and is up-to-date on her tetanus vaccination.Which of the following is the most appropriate management for this cat bite?

Which of the following burn injuries requires immediate referral to a burn center?