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James, a 45-year-old truck driver, presents with low back pa…

James, a 45-year-old truck driver, presents with low back pain of gradual onset. There is no history of trauma, the pain is relieved by lying down, and his neurologic exam is normal. You initially start conservative management with NSAIDs and muscle relaxants. Three days later, he calls your office still experiencing pain and expresses concern that it might be serious. He denies any numbness, tingling, or incontinence. What is the best next step in management?  

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A 34-year-old female fast food worker presents with bilatera…

A 34-year-old female fast food worker presents with bilateral heel pain that is most intense with her first steps in the morning, eases after moving around, but returns by the end of the day. She denies fever, chills, or recent trauma. On exam, there is localized tenderness over the plantar surface of the heels without erythema, swelling, or deformity. What is the most likely diagnosis?  

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During a physical exam, the nurse practitioner performs Tine…

During a physical exam, the nurse practitioner performs Tinel’s sign and Phalen’s maneuver. These special tests are used to help diagnose which of the following conditions?  

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A 2-year-old boy is diagnosed with physiological (retractile…

A 2-year-old boy is diagnosed with physiological (retractile) cryptorchidism. During your physical exam, which of the following findings would you most likely observe?

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Diagnostic testing to identify and guide treatment of acute…

Diagnostic testing to identify and guide treatment of acute bacterial prostatitis is best accomplished by obtaining which of the following?  

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_____ is a congenital abnormality characterized by the ureth…

_____ is a congenital abnormality characterized by the urethral opening located on the ventral (underside) surface of the penis, often associated with a ventral curvature of the shaft (chordee).

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A 3-year-old girl with a history of recurrent febrile urinar…

A 3-year-old girl with a history of recurrent febrile urinary tract infections is found to have vesicoureteral reflux (VUR) on voiding cystourethrogram (VCUG). She is currently asymptomatic. What is the most appropriate first step in management?  

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A 45-year-old patient presents with chronic crusting and red…

A 45-year-old patient presents with chronic crusting and redness of the eyelid margins, associated with itching and burning. Visual acuity is normal. On exam, there is mild conjunctival injection and scaling at the lid margins. What is the first-line management?

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A patient presents with a painless, firm nodule on the upper…

A patient presents with a painless, firm nodule on the upper eyelid that has been present for 6 weeks. The lesion is not tender, and there are no signs of infection. What is the most appropriate initial management?

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A 3-year-old girl is brought to the clinic by her mother, wh…

A 3-year-old girl is brought to the clinic by her mother, who reports noticing a firm “lump” on the child’s left side during bath time. The child has no fever, pain, or changes in appetite. There is no history of recent trauma. On physical examination, you palpate a firm, smooth, non-tender mass in the left upper quadrant that does not cross the midline. Vital signs are stable, and there are no signs of acute illness. What is the most appropriate next step in management?

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