A four-week-old infant born at 39 weeks’ gestation, exclusively breast fed and has been healthy was brought in for an evaluation following a 2 day history of projectile vomiting that occurs after each feeding without with increased fussiness. The child's father mentioned that the baby appears to be without distress after vomiting and wants to feed immediately afterwards. Parents deny the infant has had fever, diarrhea or skin lesion; in addition, has not had exposure to individuals with similar symptoms. His last BM was about 18 hours ago, described as small and firm. Physical exam reveals an alert, active infant with a small palpable mask that is appreciated in the right upper quadrant of the abdomen. The most likely diagnosis is:

A. Viral gastroenteritis

B. Pyloric stenosis

C. Intussusception

D. Gastroesophageal reflux
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A 25-year-old woman gravida 2, para 1 is 24 weeks pregnant and is being seen for an urgent care visit. She reports a constant headache over the past two days along with ankle swelling. Her BP today is 162/86 in, which is a significant elevation from her pre pregnancy blood pressure of 122/68.Laboratory results indicate 2 plus proteinuria as well as elevated ALT and AST. Platelets and LDH are within normal limits, as is fundoscopic and neurological exams. The most likely diagnosis is:

A. Health syndrome

B. Gestational hypertension

C. Preeclampsia

D. Hypertensive emergency
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YouTube: https://www.youtube.com/watch?v=-HSR0zonmZA&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=93

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A 77-year-old man is in for a routine follow up visit. He has its twenty-year history of type 2 diabetes and hypertension as well as a 5-year history of stage 3B chronic kidney disease, or CKB. At this visit, his A1C is 8.4% and his estimated GFR is 42 mL per minute. His BP is 128/76. He states he's feeling well and denies headache, visual changes, dizziness and hypoglycemic episodes. His medications include metformin, amlodipine, lisinopril and rosuvastatin. In reviewing his current medication, the NP considers which of the following options?

A. Prescribe glipizide

B. Add pioglitazone

C. Continue on his current medication without adjustment

D. Initiate therapy with Canagliflozin
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YouTube: https://www.youtube.com/watch?v=rOuR7ATNdMQ&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=92

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