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?

A 50 year old male who presents with heart burn for the past 3 months daily is diagnosed with gastroesophageal reflux disease (GERD).  Which is first line treatment for this patient?

Which of the following is a true statement regarding kidney stones?

A 36 year old male presents to the office for a discolored toenail. He noticed it about 3-4 weeks ago and it is not getting better. You advise him it is likely onychomycosis of the nail. Which of the following is true?

A patient diagnosed with a cluster headache would exhibit which of the following?

A 53 year old African American male presents to your office for follow-up. He was diagnosed with hypertension 3 months ago and is currently taking HCTZ 25 mg daily. He reports that he is feeling well and denies any complaints of lower extremity swelling, chest pain, shortness of breath or headaches. His physical exam reveals the following: BP: 150/87, HR: 73, RR 14, Temp 98.6, O2 Sat 100% and normal ECG. His PE is normal. What is the next best step in management of this patient?

A 32 year old male presents to the office for left upper abdominal pain. He reports it started this morning when he awoke. He complains of nausea, vomiting, and decreased appetite. He has a history of alcohol abuse.  You suspect he has pancreatitis and explain that his treatment will include