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**If you would like another chance to read the challenge before seeing the answer, click here. Scroll down for the answer. ** ———————————————————————————————————————————————————————————– The correct answer is C) Acute promyelocytic leukemia. This was a challenging case and differential, but the presentation and smear were classic and are exactly what you would be […]
February 2, 2014
A 25 year-old otherwise healthy male presents to his primary care doctor after a difficult to control nosebleed, lasting approximately two hours. There is no history of trauma, drug use, or previous episodes of prolonged bleeding. He has not been feeling fatigued lately (able to carry out his usual activities). He does endorse easy bruising […]
October 5, 2013
**If you would like another chance to read the challenge before seeing the answer, click here. Scroll down for the answer. ** ———————————————————————————————————————————————————————————– The correct answer is Aspiration Pneumonitis (D). Explanations of the choices follow, and management of the patient is discussed at the bottom of the page. Don’t feel bad if you chose Pneumoperitoneum (A) – […]
October 3, 2013
An 80 year old male with multiple medical problems (including CAD, COPD and atrial fibrillation) is undergoing evaluation for progressive early satiety and vomiting after meals for the past year. A peri-pancreatic mass causing extrinsic compression of the gastric outlet near is discovered on abdominal imaging, and upper endoscopy with endoscopic ultrasound and fine needle […]
August 1, 2013
**If you would like another chance to read the challenge before seeing the answer, click here. Scroll down for the answer. ** ———————————————————————————————————————————————————————————– The correct answer is Medication induced delirium (G). This was a difficult case, but with the information provided the most likely answer should be clear. It’s an important topic, as this is a commonly-encountered clinical […]
July 12, 2013
This medical challenge is adapted from a real clinical scenario, and though complex, is an excellent example of the broad differential required for an elderly person with a change in mental status – one of the most common presentations to the emergency department. An 80 year old white male is brought to the emergency department […]
March 25, 2013
**If you would like another chance to read the challenge before seeing the answer, click here. Scroll down for the answer. ** ———————————————————————————————————————————————————————— The correct answer is D) Nephrolithiasis. Some of you chose the correct condition, but on the wrong side of the body. Remember that the patient had pain on the left, and that […]
March 23, 2013
Case: A 43 year old female presents to the emergency department complaining of sudden-onset, sharp, left-sided abdominal pain that radiates to the groin, followed by nausea, vomiting, and diarrhea. Based on the images and history provided above, what is the most likely diagnosis? A) Appendicitis B) Diverticulitis C) Hernia D) Nephrolithiasis (kidney stone) E) Ruptured […]
August 21, 2012
**If you would like another chance to read the challenge before seeing the answer, click here. Scroll down for the answer. ** ———————————————————————————————————————————————————————————– Let me begin by saying this was a difficult case (I know a case is tricky when the ratio of views to answers is >400:1), and kudos to those who tried – […]
August 19, 2012
You are the GI fellow consulted to see a 17 year old white male with a chief complaint of diarrhea & bright red blood per rectum (BRBPR). The patient was in his usual state of health until he experienced sudden-onset diffuse, crampy abdominal pain and diarrhea roughly 36 hours ago. He experienced 3-5 episodes of […]
Abnormal Facies 
February 5, 2014
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