Caprini ScoreDownload

What is the diagnosis?The chest radiograph shows air in the pericardium. Computed tomography of the chest confirmed the presence of a large pneumopericardium but no pneumothorax. The patients vital…

A 65-year-old man presents to his primary care physician complaining of a hoarse voice for 6 months. He smokes one pack of cigarettes daily and also drinks at least a six pack of beer daily. His ph…

Hypoglycemia is uncommon in patients who are not treated with insulin or sulfonylureas for diabetes mellitus. However, it can occur in those with sepsis or other critical illnesses due to increased…

An open-label randomized parallel-arm active study evaluated the safety and efficacy of a continuous infusion of potassium chloride versus an existing intermittent infusion regimen in critically il…

Capnography and Pulse OximetryDownload

Cannabinoid ToxicityDownload

What is the diagnosis? Mesenteric ischemiaAbdominal computed tomography with contrast material shows occlusion of the main trunk of the superior mesenteric artery with mesenteric venous gas and pne…

What is the diagnosis? The patient is diaphoretic, cachectic, and has a diffusely enlarged thyroid. These features are most consistent with Graves’ disease. The patient had substantial improv…

Cannabidiol (CBD) in Clinical CareDownload

This patient had hypercalcemia with a suppressed parathyroid hormone level. What is the diagnosis? Bilateral hilar lymphadenopathy with hypercalcemia and a suppressed parathyroid hormone level is m…

A 40-year-old female presented to the physician for evaluation of worsening fatigue. She has no other medical problems. She does not use tobacco, alcohol or drugs. Vital signs are within normal lim…

A 63-year-old man is treated with paclitaxel and carboplatin chemotherapy for stage IIIB adenocarcinoma of the lung. He presents for evaluation of a fever to 38.3°C. He is found to have erythema at…

A 24-year-old woman is seen in follow-up 12 months after an allogeneic stem cell transplantation for acute myeloid leukemia. She is doing well without evidence of recurrent disease but has had mani…

A 66-year-old man with chronic obstructive pulmonary disease presented to the emergency department with a 2-week history of shortness of breath and cough and 5 days of left flank pain. Two days bef…

All 3 modalities are equally effective, but surgery and radioactive iodine ablation can permanently treat hyperthyroidism. However, the physician should discuss the options with the patient to make…

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Glucose is freely filtered at the glomerulus and is promptly reabsorbed in the proximal tubule by a sodium-coupled active transport mechanism (ie, sodium-glucose cotransporter-2 [SGLT-2]). Normally…

A 49-year-old man with acute myeloid leukemia who had been admitted to the hospital for induction chemotherapy was evaluated for prolonged neutropenic fever. On physical examination, crackles were …

A  confidence interval (CI) is a range of plausible values calculated from sample data that captures the true population value with a confidence level. The confidence level  refers to how…

CachexiaDownload

Acute Pericarditis Due To Post-Cardiac Injury (Dressler) syndrome (PCIS). This condition results from immune-complex deposition in the pericardium and pleura that can occur following any event or i…

Acute Renal Failure (ARF) (eg, low urine output, high blood urea nitrogen)  can be classified according to 1 of 3 etiologies: • Prerenal: Caused by decreased renal perfusion; the nephrons rema…

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Burning Mouth SyndromeDownload

This lateral radiograph of the neck shows a ‘thumb sign,’ a manifestation of an enlarged and edematous epiglottis/Epiglottitis. The patient was hospitalized and responded to antibiotic …

A 44-year-old man comes to the hospital due to acute onset of central chest pain radiating to the left arm. He used cocaine a few hours ago. Blood pressure is 160/100 mm Hg, pulse is 98/min, and re…

Recommended add-on therapy for patients with diabetes and established cardiovascular disease (eg, heart failure, myocardial infarction, coronary artery disease) includes the following: · Sodium-glu…

COVID-19 can affect the cardiovascular system both during acute infection and weeks to months afterward. The spectrum ranges from transient biomarker elevation to myocarditis, arrhythmias, thrombos…

Burn Debridement, Grafting, and ReconstructionDownload

What is the diagnosis? MeningiomaOsteitis fibrosa cysticaPaget’s diseasePlasmacytoma Thalassemia The computed tomographic scan showed a destructive, well-demarcated, soft-tissue mass, with pe…

A 30-year-old man comes to the emergency department with a 4-day history of progressively worsening abdominal pain and bloody diarrhea. He was started on mesalamine therapy 6 months ago after being…

Lateral ankle sprains are typically caused by forceful inversion of the foot during running, walking on uneven surfaces (eg, descending stairs), or a fall from height. The anterior talofibular liga…

A 46-year-old man comes to the emergency department for evaluation of left ankle pain. The patient was walking down a flight of stairs when he missed a step and landed on the lateral aspect of his …

Bullous EmphysemaDownload

A 6-month-old baby boy was transferred to a quaternary children’s hospital for evaluation and management of seizures. One week earlier, he had had decreased oral intake, vomiting, and irritability.…

Porcelain Gallbladder, a term used to describe the calcium-laden gallbladder wall with bluish color and brittle consistency is often associated with chronic cholecystitis. The pathogenesis of the c…

BronchoscopyDownload

A 42-year-old man on prolonged immunosuppressive therapy for chronic graft-versus-host disease after stem-cell transplantation for acute lymphoblastic leukemia presented to clinic with a 2-week his…

Thyroid function tests often are abnormal in patients with severe, acute illness. Euthyroid Sick Syndrome (ESS) is a common pattern of thyroid function markers often seen in hospitalized patients. …

Unconjugated bilirubin, a byproduct of red blood cell destruction, is normally elevated in all newborns. It is typically bound to plasma albumin, which prevents it from crossing the immature neonat…

Bilirubin-Induced Neurologic Dysfunction (BIND)Unconjugated bilirubin, a byproduct of red blood cell destruction, is normally elevated in all newborns. It is typically bound to plasma albumin, whic…

Bronchopleural FistulaDownload

A 16-year-old boy presented with a painless swelling of the left upper eyelid for 1 month, with no history of trauma. Examination revealed 2 hard, well-defined whitish projections arising from a fu…

This patient likely has a ruptured Popliteal (Baker) Cyst A popliteal cyst is due to extrusion of synovial fluid from the knee joint into the gastrocnemius or semimembranosus bursa through a commun…

A 24-year-old woman is seen in follow-up 12 months after an allogeneic stem cell transplantation for acute myeloid leukemia. She is doing well without evidence of recurrent disease but has hadmanif…

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and indomethacin, inhibit prostaglandin synthesis, leading to decreased renal prostaglandin levels. In healthy individual…

Exogenous Lipoid Pneumonia.A 38-year-old woman was referred to the pulmonary clinic for evaluation of an opacity in the right lower lobe seen on chest radiography. She had no respiratory symptoms b…

A 50-year-old woman is seen by her primary care physician for spontaneous nipple discharge of the right breast associated with a small palpable mass adjacent to the nipple. She reports no fevers. W…

Hypercalcemia can be categorized as either parathyroid hormone (PTH) dependent (high-normal or increased PTH [eg, hyperparathyroidism]) or independent (low/suppressed PTH).Humoral hypercalcemia of …