65 year old Asian female falls forward after being tripped by her cat as it was rubbing her legs for attention. As she falls forward she tries to catch herself with her right hand with right wrist extended and feels a sharp pain afterward. Later she goes to the ER for X-rays of the right […]

55 year old female has a history of joint stiffness in the morning for years and was found to have a positive ANA, rheumatoid factor and anti-CCP antibody. Hand x-rays show gross joint destruction of many joints and she has rheumatoid nodules present on the elbows. What is the likely diagnosis? 55 year old female […]

A patient in their 20’s presents with back pain, dactylitis, sacroiliitis, and has been found to be HLA-B27 positive. What is the likely diagnosis? A patient in their 20’s presents with back pain, dactylitis, sacroiliitis, and has been found to be HLA-B27 positive. What is the likely diagnosis? Ankylosing spondylitis SLE Psoriatic arthritis Rheumatoid arthritis

A 22-year-old woman presents to discuss fatigue. She can fall asleep easily, including falling asleep last week at a red light while driving. She also describes a transient paralysis that happens whenever she hears something funny or has an orgasm. Findings on her physical examination are normal. Which of the following is the most appropriate […]

A 56-year-old man presents for evaluation of cognitive decline. He is diagnosed with major neurocognitive disorder due to another medical condition. Serum analysis is notable for elevated anti-double-stranded DNA antibodies. Which of the following is the most likely cause of this patient’s neurocognitive disorder? Ankylosing spondylitis Rheumatoid arthritis Scleroderma Systemic lupus erythematosus

After a fall at home, a 77-year-old woman was brought to the emergency department and received level 3 E/M services. The patient sustained a 2 cm laceration of the thigh and a small, 0.5 cm laceration of the wrist. The thigh wound was closed with sutures and the wrist laceration underwent adhesive closure. The patient […]

A 45-year-old Black man is here for a general annual physical. He denies that there are any current problems bothering him. Current vital signs include 98.6°F (37°C), blood pressure 160/100 mm Hg, heart rate (HR) 88 beats/min; respiratory rate (RR) 18 breaths/min; oxygen saturation 99% on room air. He reports he had his annual laboratory […]

A 54-year-old woman was brought to the ER by her daughter, who reported that her mother had blurred vision, dizziness, and slurred speech. Upon questioning, her daughter reported that they both had recently spent a weekend at a medical spa, during which they both had cosmetic injections to reduce wrinkles. What do you suspect is […]

An 80-year-old patient was admitted to the outpatient surgery center for dilation of a urethral stricture with insertion of urethral stent. A cystourethroscope was inserted through the urethral meatus and advanced through the urethra into the bladder. It was able to pass through the site of stricture successfully, although with some difficulty. Examination of the […]

A 10-year-old presents having fallen approximately 2 hours ago. Ice was applied, however, swelling and pain continues. ED physician performs ROS involving four systems. Patient lives at home and attends grade school in the area. Multiple systems are evaluated. Multiple x-rays are obtained as well as labs and independent evaluation of x-rays and discussion of […]