A 23-year-old man complains of lower back pain that began approximately 6 months ago. He is unsure why he is experiencing this pain and notices that this pain is worse in the morning after waking up and improves with physical activity. Ibuprofen provides significant relief. He denies bowel and bladder incontinence or erectile dysfunction. Physical exam is notable for decreased chest expansion, decreased spinal range of motion, 5/5 strength in both lower extremities, 2+ patellar reflexes bilaterally, and an absence of saddle anesthesia. Which of the following is the most appropriate next test for this patient?
AHLA-B27
BSlit-lamp examination
CMRI sacroiliac joint
DRadiograph sacroiliac joint
EESR
A 33-year-old man presents to his primary care physician with shoulder pain. He states that he can't remember a specific instance when the injury occurred. He is a weight lifter and competes in martial arts. The patient has no past medical history and is currently taking a multivitamin. Physical exam demonstrates pain with abduction of the patient's right shoulder and with external rotation of the right arm. There is subacromial tenderness with palpation. His left arm demonstrates 10/10 strength with abduction as compared to 4/10 strength with abduction of the right arm. Which of the following best confirms the underlying diagnosis?
AUltrasound
BRadiography
CMRI
DCT
EPhysical exam and history
A 50-year-old man presents with severe chest pain for a week. His pain increases with breathing and is localized to the right. He has tried over-the-counter medications at home, but they did not help. The patient has a 20-pack-year smoking history and currently smokes 2 packs of cigarettes daily, and he drinks 3 to 4 cans of beer daily before dinner. His temperature is 39.1°C (102.3°F), blood pressure is 127/85 mm Hg, pulse is 109/min, and respirations are 20/min. Respiratory examination shows dullness to percussion from the 7th rib inferiorly at the right midaxillary line, decreased vocal tactile fremitus, and diminished breath sounds in the same area. Chest radiograph is shown in the image. The patient is prepared for thoracocentesis. Which of the following locations would be the most appropriate for insertion of a chest tube?
ABelow the inferior border of the 7th rib in the midaxillary line
BAbove the superior border of the 8th rib in the midaxillary line
CAbove the superior border of the 5th rib in the midclavicular line
DBelow the inferior border of the 5th rib in the midaxillary line
EAbove the superior border of the 7th rib in the midclavicular line
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