A 36-year-old female was working on her deck 2 hours ago when her thumb got caught between two planks of wood. She is reporting severe persistent pain in the left thumb nail and states it seems to be getting worse. On exam the patient’s thumb nail has black/purplish discoloration underneath the intact nail. She maintains normal AROM, and is neurovascularly intact. There is a XR negative for fracture. Based on her exam, what is your diagnosis and what would you recommend? 

Given this clinical scenario, what is your top differential diagnosis?

A 45 year old patient with known coronary disease as well as Type 2 diabetes has the following lipid panel:  LDL 128, HDL 30, and Triglycerides 208.  What should the first line treatment be?

What would you expect to find on this patient’s Pulmonary Function Test?

What is your treatment plan for this patient?

Match the following symptoms with mania versus depression 

AAA is a potentially fatal condition due to slow growth and asymptomatic nature of the condition. USPSTF recommends which of the following tests to screen for this condition in high-risk individuals?

A 68 year old patient with a history of type 2 diabetes is diagnosed with hypertension.  Which medication should the patient be started on first line?

Another patient presents to the clinic post bar fight and is noted to have swelling around the right orbit. The patient is conscious but unable to see out of the right eye. You mechanically manipulate the eyelid and determine an open globe rupture. What is your initial treatment? 

An adult patient reports occasional anal bleeding with defecation and pruritis. On examination the nurse practitioner notes non-thrombosed external hemorrhoids around the anal orifice as the patient is bearing down. The hemorrhoids are not actively bleeding. Patient is afebrile and does not have any other associated symptoms and physical exam is otherwise unremarkable. What is the initial treatment for symptoms?