Case Challenges

 
 
  • A 19-Year-Old Shooting Victim With Complications Five weeks after polytrauma from multiple gunshot wounds, a 19-year-old man is experiencing diffuse right-sided chest pain and shortness of breath. Can you make the diagnosis?
  • A 77-Year-Old Retired Teacher With a Constant Headache A 77-year-old retired teacher presents to the emergency department with dizziness, imbalance, nausea/vomiting, and a constant headache for the past 2 weeks. Can you make the diagnosis?
  • A 12-Year-Old Boy With Falling Grades and Forgetful Behavior A 12-year-old boy with declining grades is disruptive at school, forgetful at home, and upset by tasks that are time consuming or cognitively demanding.
  • A 45-Year-Old Woman Who Feels 'Like a Zombie' A 45-year-old woman states that she feels 'like a zombie.' She has experienced continued confusion and sedation long after a respiratory illness resolved. Can you make the diagnosis?
  • A 14-Year-Old Boy With Unexplained, Recurring Fever A 14-year-old boy presents with a 2-week history of unrelenting fever and generalized fatigue. What is the most likely diagnosis?
  • A 20-Year-Old Woman With Nail Abnormalities and Vomiting A 20-year-old woman presents with flank pain and vomiting, along with periungual fibromas. What's the diagnosis?
  • A 26-Year-Old Man Who Passed Out at His Work Desk Paramedics bring a 26-year-old man to the ED with acute-onset altered mental status. He has a history of back pain. An open, unlabeled pillbox was found. An ECG is ordered. What is the diagnosis?
  • A 64-Year-Old Man Unable to Lift His Arm or Walk A 64-year-old man presents with left-sided weakness that has worsened to the point where he cannot comfortably walk or lift his arm. What's the diagnosis?
  • A 29-Year-Old Woman With Worsening Pain and Memory Issues A 29-year-old woman presents with multiple joint and muscle pain, back pain, and increasing fatigue. She is also suffering from depression, as well as memory and concentration problems.
  • A 31-Year-Old Woman With Right Arm Tremors A 31-year-old woman has had tremors in her right hand and arm over the past month. She is otherwise in good health and has not needed to see a doctor in years. Can you make the diagnosis?
  • A 17-Year-Old Athlete in Cardiac Arrest A 17-year-old boy drops to the ground and is unresponsive after being elbowed by a teammate who ran into him. CPR is initiated, and the patient is taken to the ED. What is the likely diagnosis?
  • A 64-Year-Old Man With Back Pain After Mastectomy A 64-year-old man presents with right lower back pain 7 years after mastectomy for breast cancer. Can you make the diagnosis?
  • An 84-Year-Old With a Blistering Rash That Is Spreading An 84-year-old woman presents with a blistering rash. The rash began 1 week ago on her right hand, but it has progressed to her arm, upper chest, and abdomen. What's the diagnosis?
  • Acute Liver Failure in a 64-Year-Old Man A 64-year-old man with a history of chronic obstructive pulmonary disease, alcohol abuse, and depression presents with acute hepatic failure. Can you identify the correct cause?
  • A 22-Year-Old Man in Pain After Collapsing A 22-year-old man presents after collapsing on a college football field about 45 minutes earlier, after doing several 50-yard sprints. Can you make the challenging diagnosis?
  • A 32-Year-Old Man Vomiting Blood A 32-year-old man reports having vomited bright-red blood three times during the past 4 hours; the last incident occurred about 1 hour ago. What's the diagnosis?
  • A 4-Year-Old Girl in Significant Distress A 4-year-old girl develops a swollen leg after admission to the hospital after presenting with frequent urination, excessive thirst, and new-onset enuresis. Can you solve this unusual case?
  • Sleep Problems and Odd Behavior in a 60-Year-Old Woman A 60-year-old woman reports awakening without feeling rested every morning. Her daughter reports that her mother has also had recent problems with attention and 'losing things.' What's the cause?
  • A 21-Year-Old Man With Epigastric Pain After a Wild Party A 21-year-old man presents to the ED with a 10-hour history of constant epigastric pain radiating to the chest. X-rays reveal a radio-opaque shadow in the central lower chest. What is the diagnosis?
  • A 44-Year-Old Man Who Had a Mysterious Accident A 44-year-old white man with a medical history remarkable for hypertension and dyslipidemia presents with fatigue and global weakness. What's the diagnosis?