A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.

Her vital signs are as follows:

Heart rate: 94/min

Blood pressure: 130/80 mm Hg

Temperature: 37.3 °C

A non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associated

hydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

A 37-year-old man comes to the office for follow-up of his opioid use disorder. He receives opioid agonist treatment, including some take-home doses. At this follow-up visit, he reports some nonprescription opioid use since his last visit. Which one of the following is the best next step?

A 60-year-old woman presents with a 7-day history of bloody diarrhea and diffuse mild abdominal tenderness. Stool tests (culture, ova/parasites) are negative. Which one of the following is the best next step?

A 38-year-old man is brought by his wife to the Emergency Department with fatigue, dizziness, and nausea

after completing a hiking tour on a hot, humid day. His wife became worried after he had collapsed. He has

been sweating heavily and vomited twice on the drive in. His medical history is unremarkable, and he takes

no medications. His vital signs on arrival are as follows:

Blood pressure

85/57 mm Hg

Heart rate

120/min

Respiratory rate

18/min

Temperature

40.1 °C

Oxygen saturation

95%, room air

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On physical examination, the patient's skin is dry, flushed, and warm to the touch. He has a diffuse

erythematous papular rash. Findings of a thorough physical examination are otherwise unremarkable. An

electrocardiogram shows sinus tachycardia. Which one of the following is the best next step?

A 94-year-old woman with severe dementia is referred for vaginal bleeding and a persistent foul odour from the vagina. She lives in a long-term care facility. She has been using a ring pessary for the past 15 years. Her current pessary has not been replaced in 2 years. On examination, there is moderate vaginal atrophy. After removing the pessary, which one of the following is the best next step?