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?

A 38-year-old office worker presents with numbness, tingling, and occasional burning pain in her right hand, particularly in the thumb, index, and middle fingers. She reports that the symptoms worsen after typing for long periods and sometimes wake her up at night. On physical exam, you notice decreased sensation in the affected fingers and weakness in thumb abduction. She also reports pain when you tap on her wrist over the median nerve.Which of the following is the most appropriate diagnostic test to confirm carpal tunnel syndrome in this patient?

A previously healthy patient reports a sensation of one knee locking or feeling like it will give way when descending stairs.  The patient has no recollection of injury to the knee and denies pain.  What is the most likely treatment for this disorder? 

Mr. Joynt is a 67-year-old carpenter complaining of morning stiffness and mild pain in his fingers and right knee upon awakening. He feels some relief after warming up. On exam, the nurse notices the presence of Herberden’s nodes on distal fingers. Which of the following conditions is most likely?

A 38-year-old male with a diagnosis of systemic sclerosis presents with complaints of shortness of breath and dry cough. On physical examination, you note diminished breath sounds in both lower lung fields and crackles on auscultation. His pulmonary function tests show a restrictive pattern.Which of the following is the most common pulmonary complication of systemic sclerosis?

A 20-year-old female presents with a complaint of neck fullness and a lump that she noticed. She denies pain, but her mother had thyroid cancer in her 60s. On physical exam, you palpate a firm, non-tender nodule in the right lobe of the thyroid. The patient is otherwise healthy with no symptoms of hyperthyroidism or hypothyroidism. You order a TSH and it is elevated. Which of the following is the next additional step in evaluating this patient?