My patient is a 42-year-old woman with obesity who presents with a subacute course of increasingly frequent post-prandial epigastric and right upper quadrant pain associated with nausea and vomiting. The episodes can last several hours and she feels well between them. She is afebrile and is not jaundiced. This is likely biliary colic. I would like to evaluate with a right upper quadrant ultrasound. Peptic ulcer disease is also possible but she doesn’t have risk factors for that My patient is a 61-year-old man with a history of uncontrolled hypertension and tobacco use who presents with subacute worsening dyspnea on exertion relieved by rest and orthopnea. He also has had some non-painful bilateral lower extremity edema. He does not have any chest pain or infectious symptoms. This is most likely a new diagnosis of heart failure, and I would like to evaluate with echocardiography. Chronic lung disease like COPD is possible but think this is a less likely cause of his presentation because of the orthopnea and lower extremity swelling My patient is a 6-year-old with a history of recurrent streptococcal pharyngitis who presents with acute onset fevers and sore throat, cervical adenopathy, and erythematous tonsils with exudate. He has had sick contacts at school with streptococcal pharyngitis. Despite the fact he had a negative rapid test for strep, his presentation is clinically consistent with strep throat and he is at high risk based on his personal history and sick contacts. I would like to proceed with treatment for strep throat and we can send the swab for culture. Infectious mononucleosis could cause similar ndings but would be less likely in his age group