As part of the monitoring for a patient being treated for Rheumatoid Arthritis with methotrexate, which of the following should be considered?

You diagnose PUD caused by H.Pylori.  First line treatment for this patient is which of the following?

A 27 year old male presents to the office for follow-up to a rash. He has no significant past medical history except for Acne for which he is taking clindamyacin as he was allergic to tetracycline. His labs show a positive IgM for Borrelia with a positive Western Blot. Which of the following medications would be the best treatment?

A 56 year old white male presents to your office for new onset hypertension. His blood pressure is 160/92. He has no other medical problems, what is the best choice for him?

A 42 year old male with asthma also needs anthypertensive therapy. Which of the following should you avoid prescribing for him?

A 22 year old female presents to the office for vaginal discharge. She is sexually active and has had 4 partners in the last 3 months and 6 partners in the last year. She has an IUD and uses condoms occasionally. She reports the discharge has a foul odor to it and is yellowish. She complains of vaginal irritation and some discomfort with urination. On wet mount she has a positive whiff test, with motile flagella and no clue cells. What is your treatment plan for this patient?

A 35 year old female presents to the office complaining of daily headaches lasting about 2-3 hours after work for the past 2 months. She describes bilateral pain which is not aggravated by activity. She denies nausea, vomiting or sensitivity to light. She works as a social worker for the county and has been working a lot of overtime. Her vital signs and exam are normal. She is taking tylenol and ibuprofen with minimal symptomatic relief. What is the most likely diagnosis and treatment?

A 21 year old female presents to the office for vaginal discharge and itch for the past 3 days. She is sexually active and takes Ortho Tri Cyclen for her birth control. She does not use condoms. On exam you note thick white discharge and on microscopic exam you note budding yeast. What is her diagnosis and treatment plan?

A 22 year old female presents to the office with complaints of a headache. She notes the headaches come around the time of her cycle and are very debilitating for her. She notes nausea, vomiting and light sensitivity. She has tried tylenol, advil and aleve and does not have relief with these medications. She indicates she has these headaches 2-3x a month. She has no other medical problems and her vital signs are all normal. What would you recommend for her?

A 45 year old male presents to your office complaining of back pain for 2 days. He notes the pain is getting progressively worse and has experienced some urinary incontinence. He indicates that he has a “funny feeling” around his buttocks and is now getting worried because he had an episode of fecal incontinence this morning. What is your plan for this patient?