A 47- year-old female is concerned about a change in her menstrual pattern. Her monthly periods continue, but for the past several months they have been havier than usual and have been lasting a few days longer. Last month she also noted some spoting for several days piror to onset of her menses. Her pelvic examination is normal.

Which of the following would be the most appropriate at this time?

A patient is brought to your office by his spouse because of anger issues over the past 6 weeks that are affecting his marriage and is work. He tells you he has started running 5 miles per day, but is sleeping poorly, and that his mind has been racing during this period. He recently went on a shopping spree and reached the maximum spending limit on his credit card. He has been using alcohol to calm down. He refuses to see a psychiatrist.

The most appropriate medication to initiate at this time is

A 45- year- old male comes to the UC center with left foot pain that begins at a ballroom dancing competition. He sates that he put all his weight on the lateral position of his foot while on tiptoe, and felt the pain immediately. He now can’t bear weight on the foot. On examination it appears slightly edematous with a small amount of ecchymosis. A radiograph reveals a proximal fifth metatarsal metadiaphyseal fracture. The patient is eager to return to competitive dancing as soon as possible.

Which one of the following would be the best treatment for this patient?

A 45 –year- omd female comes to your outpatient clinic for a routine health maintenance examination. She has no complains, is generally healthy, and has an unremarkable family history. She has been having regular periods and sexually active with her husband, who had a vasectomy 9 years ago. As you perform a pelvic examination you notice a fullness in the left adnexal region that is mildly tender to palpation. The remainder of the examination is normal. You order pelvic US, which demonstrates a 4x5- cm cystic structure on the left ovary. There are no internal septations or echogenic internal structures. A pregnancy test is negative.

Which one of the following would be most appropriate at this point?

A 4-year-old female is brought in by her mother because of 3-day history of left ear drainage and low grade fever. The patient has bilateral ventilation tubes that were placed 2 months ago.

Which one of the following would be most effective for resolving this child’s condition?

Which one of the following is appropriate in the care of adolescent patient?

Which of the following population should be screened for asymptomatic bacteriuria?

A 60-year-old male sees you for a routine health maintenance visit. One of the patient’s friends recently underwent screening for an abdominal aortic aneurism (AAA), and he asks if he should be screened. He’s asymptomatic, has newer smoked and has no other risk factors.

Which one of the following does the USPSTF advise in regards to AAA screening for this patient?

A 55 -year-old male presents with SOB and abdominal pain. He has a history of DM, CAD, Hep C. He usually is very active and continues to work in steel plant. He smokes one pack a day and drinks ETOH daily. A CXR shows a moderate right sided pleural effusion. Thoracentesis reveals a pleural fluid protein to serum protein ratio of 0.3, pleural LDH to serum ratio 0.4. The pleural Glu level is 140 mg/dl and his BG level is 150 mg/dl.

Which one of the following is the most likely cause of the pleural effusion?