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What's Causing This Child's Rectal Bleeding?
A child presents to the ER with several days of rectal bleeding. The mother first noticed reddish-colored stools 2 days prior to arrival and has since changed several diapers with just blood. The child is afebrile, alert, and playful, and is eating well without emesis. He is slightly tachycardic, and his abdominal examination is normal. What is the best diagnostic study to order at this time?
January 06, 2016
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A Woman with Discomfort and Rash: Diagnosis?
A woman has limb discomfort and trouble getting off the toilet and climbing stairs. She has noticed a rash on her face about her eyes. She is also found to have weakness about the hip and shoulder girdle. She also has erythematous discoloration over the finger joints and purplish nodules over the elbows and knees. What is the most likely diagnosis?
December 30, 2015
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What's Causing This Boy's Bleeding?
A boy is admitted to the hospital due to bleeding. Lab test findings include a platelet count of 50,000/microliter, prothrombin time (PT) of 15 s (control 11.5 s), activated partial thromboplastin time (aPTT) of 51 s (control 36 s), thrombin time (TT) of 13.7 s (control 10.5 s), and factor VIII level of 14 percent (normal 38 to 178 percent). What is likely the cause of his bleeding?
December 23, 2015
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Why Is This Immobilized Teen Feeling Nauseated?
A 15-year-old boy has been immobilized in a double hip spica for 6 weeks after having fractured his femur in a skiing accident. He has become depressed and listless during the past few days, has complained of nausea and constipation, and is found to have microscopic hematuria and a blood pressure of 150/100 mmHg. What is the appropriate course of action?
December 16, 2015
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What Caused This Patient's Spinal Lesion?
A patient from Brazil presents to the hospital with a subacute, worsening paraparesis. The patient had worked in the lumber industry deep in the Amazon jungle. MRI of the spine is abnormal and a biopsy reveals widespread granulomas. One granuloma contains an ovoid mass with a spine extending from one side, a parasitic ovum. What is the most likely cause of the lesion?
December 09, 2015
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Gait Disorder, Dysmetria, Enlarged Liver and Spleen: What Other Symptoms Are Likely?
A woman has progressive gait disorder and dysmetria. Laboratory studies reveal excess protein and some RBCs in the urine. Urine culture is negative. The initial physical examination reveals an enlarged liver and spleen. What other findings are likely?
November 25, 2015
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Newborn Having Trouble Breathing, Mass in Left Hemithorax: Diagnosis?
A woman completes a vaginal birth successfully at term, but shortly after, her baby develops respiratory distress. A chest radiograph reveals a large multiloculated mass in the left hemithorax, and an NG tube reveals the stomach to be below the diaphragm. What is the likely diagnosis?
November 18, 2015
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What Condition Plagues a Taxi Driver Who Constantly Imagines He Ran Over a Pedestrian?
A taxi driver is chronically consumed by fears of having accidentally run over a pedestrian. His anxiety continues to mount until he drives back to the scene of the "accident" and proves to himself that nobody lies hurt in the street. This behavior is an example of what condition?
November 11, 2015
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What Ails an Otherwise Healthy Boy With Abnormal Breast Swelling?
A 14-year old boy's chief complaint is left breast swelling, but he reports no other problems. Further examination finds nothing else wrong, so what is the suggested diagnosis and treatment?
November 04, 2015
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Woman Slashes Wrists, Insists She Isn't Suicidal: Diagnosis?
A woman is admitted to the psychiatric hospital after slashing her wrists following an argument with her boyfriend. She insists she isn't suicidal and isn't hallucinating or delusional. What should you tell the patient looking for a diagnosis?
October 28, 2015
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What Is Causing a Man's Induced Nystagmus?
A man has horizontal nystagmus in his primary gaze, and while looking to both the left and the right. The only other examination finding is a slight gait ataxia. What's the likely cause?
October 21, 2015
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Boy With Abdominal Pain, Rash, Proteinuria and Microhematuria: Diagnosis?
A boy has cramp-like abdominal pain and a rash on the back of his legs, buttocks, as well as on the extensor surfaces of his forearms. Laboratory analysis reveals proteinuria and microhematuria. What is his likely diagnosis?
October 14, 2015
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What's Causing a Boy's Fever, Limp, and Conjunctivitis?
A boy is brought to the ER with numerous ailments: a 6-day fever, a limp, ocular conjunctivitis, dry and cracked lips, a red throat, and other symptoms. What is the condition at the root of this boy's troubles?
October 07, 2015
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What's the First-Line Treatment for Rash on Pregnant Woman's Abdomen?
A woman at 30 weeks gestation presents with the complaint of a new rash and itching on her abdomen. She also has a small, papular rash on her trunk and forearms, with excoriations from scratching. What is the recommended first-line treatment?
September 30, 2015
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Why Is This Hydrocephalus Patient Confused and Immobile?
Following ventriculoperitoneal shunt placement for hydrocephalus, a patient awakes very confused and complaining of a headache, unable to walk. What's the cause?
September 23, 2015
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What Meds Could Help Prevent a Recurrent Eclamptic Seizure in a Pregnant Woman?
A 20-year-old G1 at 36 weeks is being monitored for preeclampsia. What medication is recommended for the prevention of a recurrent eclamptic seizure?
September 16, 2015
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Peripheral Neuropathy Associated With Cystic Kidney Disease: Best Treatment?
A woman with cystic kidney disease, who has been on dialysis for 10 years due to renal failure, has developed peripheral neuropathy. What’s the best course of treatment for handling this condition?
September 09, 2015
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Thoracic Spine Injury Leaves Man With Pain, Paralysis and Sensation Loss: What's His Condition?
A man who injured his thoracic spine in a car accident 2 years ago still feels pain and thermal sensation loss on part of his left body and proprioception loss in his right foot, as well as paralysis of the right lower extremity. What’s his condition?
September 02, 2015
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What's Causing a Boy's Fever, Pain and Rash?
A boy returns from a Cub Scout outing with a fever, pain, and a rash. What’s the most likely diagnosis?
August 26, 2015
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Incontinence and Blurred Vision: What's the Diagnosis?
A healthy college student develops transient bladder incontinence and blurred vision. What's the most likely diagnosis?
August 19, 2015
