eMedicine CME Case Presentations Index

 
 

eMedicine CME Case Presentations presents a new case each week.

  • CME A 33-year-old Woman with Sudden-Onset Severe Headache and Vomiting A 33-year-old woman presents to the ED with a severe headache, associated vomiting, blurred vision, and weakness in her left leg. She states that it is the worst headache of her life, and it is worsening despite her use of acetaminophen. She has a 4-year history of oral contraceptive use. Her pupils show a slightly sluggish reaction to light, and bilateral papilledema is noted on the funduscopic examination. A magnetic resonance venogram (MRV) is taken. What is the diagnosis?
    eMedicine Case Presentations, May 2008
  • CME A Young Woman with General Malaise and a Persistent Fever A 21-year-old woman presents to the ED with a history of fever, general malaise, mild diffuse cramping and abdominal pain, and a cough with occasional blood-tinged sputum. She was recently diagnosed with HIV/AIDS, but she is not currently on antiretroviral medications. The patient appears cachectic and fatigued, and she is noted to be tachycardic, febrile, and has mild tachypnea. Diagnostic laboratory studies are conducted, and a chest radiograph and CT scan are taken. What is the diagnosis?
    eMedicine Case Presentations, April 2008
  • CME Dyspnea Following Initial Scuba Diving Training A 27-year-old man presents with progressive dyspnea following an initial scuba-diving training session. Approximately 1 hour into the dive, he began to feel mild chest tightness directly under his breastbone; this progressed to difficulty breathing with a frequent, nonproductive cough over the following 8 hours. The patient had accidentally held his breath as he ascended from a depth of approximately 12 ft to a depth of 10 ft in a swimming pool. What is the cause of this patient’s dyspnea?
    eMedicine Case Presentations, April 2008
  • CME A Traveler’s Fever A 17-year-old man presents to the ED with a 2-day history of headache, fever, and intermittent sweats. The patient recently returned from a 3-week trip to Nigeria. According to the patient, he felt well when he initially returned; however, today he has developed a worsening headache, bilious emesis, palpitations, and sweats. A blood smear is obtained. What is the diagnosis?
    eMedicine Case Presentations, April 2008
  • CME An Atypical Cause of Gastrointestinal Bleeding A 53-year-old man with multiple myeloma presents with a 1-week history of melena, hematemesis, and lethargy. He has no other significant past medical history, and he has not needed chemotherapy to date. The patient does not describe any symptoms suggestive of active multiple myeloma and organ involvement. He is treated with IV fluid and 2 units of blood. An esophagogastroduodenoscopy is performed. What is the cause of the abnormalities seen on the endoscopy?
    eMedicine Case Presentations, April 2008
  • CME The Unrestrained Driver A 26-year-old man is involved in a high-speed motor vehicle collision. The patient’s oropharynx is clear, his airway is patent, and his trachea appears to be shifted to the right of midline. The patient’s breath sounds are decreased and percussion of the left chest demonstrates hyperresonance. Standard trauma x-rays, including an anteroposterior (AP) chest and pelvis scan, and an emergent procedure are performed. What is the underlying pathophysiology, and what procedure was performed?
    eMedicine Case Presentations, March 2008
  • CME A 55-Year-Old Woman with Shortness of Breath and a Rapid Heart Rate A 55-year-old woman presents to the ED with severe, progressive shortness of breath, with associated chest pressure and wheezing. She has labored respirations and is unable to speak in full sentences; she also has a 40-pack-year history of tobacco use. She used her albuterol inhaler before contacting emergency medical services (EMS), with no relief of her symptoms. An ECG is performed that shows tachycardia at 152 bpm, with a left bundle branch block. What is the rhythm demonstrated on the ECG?
    eMedicine Case Presentations, March 2008
  • CME A Middle-Aged Man with Vesiculobullous Lesions on His Feet and Hands A 57-year-old man presents to the ED with a 2-week history of vesiculobullous lesions on his feet and hands that have been increasing in size and number. The patient was previously given ointment to treat the lesions, with no effect. Fluid-filled vesicles ranging in size from 1 mm to 3 cm are present on the instep and plantar aspects of his feet, as well as on the palms of his hands and sides of the fingers. The lesions are nontender to palpation. What is the skin condition being described?
    eMedicine Case Presentations, March 2008
  • CME Near-Syncope in a 24-Year-Old Man A 24-year-old man presents to the emergency department (ED) after several episodes of nearly blacking out that have occurred 3-4 times over the past 3 days. The patient states that he also felt his “heart beating really fast” and associated light-headedness. He smokes 2-4 packs of cigarettes per day and has done so for 5-6 years. No history of significant cardiac disease or sudden cardiac death in his family is noted. An electrocardiogram (ECG) is obtained. What is the diagnosis?
    eMedicine Case Presentations, March 2008
  • CME Small-Bowel Obstruction While on a Cruise A 57-year-old man presents to the emergency department (ED) with severe acute-onset abdominal pain in the right lower portion of his abdomen, along with progressive bloating, nausea, vomiting, night sweats, and low-grade fever. He has experienced intermittent abdominal discomfort with constipation and a 30-lb weight loss over the past 2-3 months. He has not been able to have a bowel movement on the day of presentation. There is a palpable mass in his right lower quadrant. What is the diagnosis?
    eMedicine Case Presentations, March 2008
  • CME Woman With an Acute Onset of Nausea and Vomiting A 46-year-old woman presents to the emergency department (ED) with constant right upper quadrant pain that radiates to her back and side. She underwent a laparoscopic cholecystectomy 2 weeks ago, without complications. Imaging shows dilated segments of bowel with a characteristic appearance. What is the diagnosis?
    eMedicine Case Presentations, February 2008
  • CME Acute Onset of Abdominal Pain in a 76-Year-Old Man A 76-year-old man presents to the emergency department (ED) with sudden-onset abdominal pain that began 4 hours ago. The pain is centered in the epigastrium and is described as deep and burning. The patient has a past medical history of coronary artery disease and hypertension, as well as one of "indigestion." Hyperactive bowel sounds are heard on auscultation. What is the diagnosis?
    eMedicine Case Presentations, February 2008
  • CME Fleshy Lesions on a 32-Year-Old Woman A 32-year-old woman presents to the emergency department (ED) with several flesh-colored papules and patches with well-defined borders on her face, trunk, and upper extremities. She first developed the lesions at 10 years of age. The patient’s medical and surgical history includes environmental allergies, frequent episodes of bronchitis, and excision of recurring skin papules. What is the diagnosis?
    eMedicine Case Presentations, February 2008
  • CME Red and Swollen Eye in a 61-Year-Old Man A 61-year-old man presents to the emergency department (ED) with a 5-day history of pain with associated redness and swelling in his right eye. The patient’s pain and swelling have worsened since he began taking acyclovir a few days ago for a presumptive diagnosis of herpes zoster infection of the eye. The affected eye demonstrates ptosis of the upper eyelid, generalized proptosis, and mild periorbital erythema with associated edema. What is the diagnosis?
    eMedicine Case Presentations, February 2008
  • CME Pink-Red Urine in a Child Who Ingested Prenatal Vitamins A 2-year-old boy presents to the emergency department (ED) several hours after ingesting an unknown number of his mother's prenatal iron tablets. He has been vomiting bright-red blood and has had 1 episode of bloody diarrhea. The consulting toxicologist recommends treatment with a specific pharmacologic agent. How was the patient treated?
    eMedicine Case Presentations, January 2008
  • CME An Elderly Man with Dyspnea A 65-year-old man presents to the emergency department (ED) complaining of worsening dyspnea on exertion associated with chest tightness, wheezing, and coughing. He smokes 2 packs of cigarettes daily. His breath sounds are diminished throughout, and the cardiac examination reveals distant heart sounds with a somewhat prominent P2. What is the diagnosis?
    eMedicine Case Presentations, January 2008
 
 
 
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