1. A 22-year-old man has a complete proctocolectomy with end ileostomy for ulcerative colitis. That evening, he becomes confused, combative, and febrile. The area surrounding the ileostomy is erythematous and crepitant. Which of the following is the most likely causal organism?
Clostridium perfringens
Escherichia coli
Enterecoccus faecalis
Staphylococcus aureus
Streptococcus pyogenes

2. A 63-year-old man with a twenty year history of diabetes presents to the emergency room complaining of sharp colicky pain in his left flank that radiates to his testicle. His pulse is 88, blood pressure is 150/90, temperature is 99.2 F, and respiratory rate is 20. Which of the following is most likely on urinalysis?
RBC casts
Osmolarity 150
pH 4.5
RBC 30/hpf
Protein casts

3. After removal of his thyroid for follicular carcinoma, a 55-year-old man complains of perioral tingling. Serum calcium is 5.9 mg/dL, and all other labs are within normal limits. Which of the following is the best next step in management?
Intramuscular vitamin D
Oral vitamin D
Intramuscular magensium
Intravenous magensium
Intravenous calcium gluconate

4. Eighteen hours after open cholecestectomy, a 49-year-old woman