A 45-year-old female presents with painful lesions on her lower limbs and ears. She is a smoker, and has a history of recreational drug use. Purpuric, necrotic lesions are noted on both lower extremities, in ... Read more
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Updated February 27, 2019 by Figure 1
A five-year-old male with a four-day history of fever presents with a new erythematous rash. His mother says he has been coughing and sneezing for the past few days. Examination reveals conjunctivitis, grayish elevations on ... Read more
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Updated February 27, 2019 by Figure 1
A 24-year-old sexually active female presents with a three-day history of severe right upper quadrant pain that worsens on inhalation. She has a history of multiple sexual partners and does not use contraception. Examination reveals ... Read more
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Updated February 27, 2019 by Figure 1
A 62-year-old female, G3P3, presents to her gynecologist with a year-long history of worsening stress urinary incontinence. During the course of her investigation, a pelvic MRI is performed, and reveals the findings seen here. Which ... Read more
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Updated February 27, 2019 by Figure 1
A three-year-old African American boy is brought to his new pediatrician over concerns of poor growth, fatigue, and irritability. On examination, he has a large head and generalized muscular hypotonia. His left wrist demonstrates the ... Read more
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Updated February 27, 2019 by Figure 1
A 28-year-old female presents to the emergency department with an occipital headache and neck pain. She mentions her symptoms appeared after hyperextending her neck while playing tennis the day before. Examination reveals dysdiadochokinesia and decreased ... Read more
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Updated February 27, 2019 by Figure 1
A 65-year-old male presents to his family physician with complaints of increasing fatigue, dyspnea on exertion, and unintentional weight loss within the last six months. On examination, he is noted to have macroglossia and peripheral ... Read more
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Updated February 27, 2019 by Figure 1
An 80-year-old female with a history of diabetes and chronic constipation presents to the emergency department with a purple urine bag. She is currently bedridden and uses an indwelling catheter. On examination, she is hypotensive and ... Read more
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Updated February 27, 2019 by Figure 1
A 76-year-old male presents with a progressive headache, dizziness, and confusion after falling from his bed the night before. He currently takes warfarin following a mechanical valve replacement 11 years ago, and has been recently ... Read more
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Updated February 27, 2019 by Figure 1
A 75-year-old female presents with a two-year history of a persistent cough and fatigue. The cough is occasionally productive of purulent sputum. She was treated for a community-acquired pneumonia two years earlier and underwent an ... Read more
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Updated February 27, 2019 by Figure 1
A 70-year-old male is brought to the emergency department with subacute shortness of breath and fatigue. Upon searching her father’s home, his daughter reports she found his medication — a nearly empty bottle of metoprolol, ... Read more
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Updated February 27, 2019 by Figure 1
A 70-year-old female with psoriasis presents with a four-month history of worsening arthralgia. She mentions she has pain and stiffness in her big toes and most of her fingers. On examination, a telescoping finger deformity ... Read more
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Updated February 27, 2019 by Figure 1
A 32-year-old female presents with a headache and a rash on her trunk and extremities. She has had unprotected sex with multiple partners over the last two months, but denies any history of sexually transmitted ... Read more
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Updated February 27, 2019 by Figure 1
A 19-year-old female exchange student presents to the emergency department with severe abdominal pain and a swollen right knee. She has had recurrent episodes of abdominal pain for the past 5 years which last 2-3 ... Read more
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Updated February 27, 2019 by Figure 1
A 28-year-old woman presents with a one-week history of a slightly raised erythematous lesion on her chest. She has been experiencing fatigue and joint pain since taking a walk through the woods in eastern Massachusetts ... Read more
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Updated February 27, 2019 by Figure 1
A 66-year-old male with a history of hypertension presents to the emergency department with dyspnea and sharp abdominal pain radiating to his back. On examination, his blood pressure is 180/120 mm Hg. A CT scan ... Read more
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Updated February 27, 2019 by Figure 1
25-year-old male presents to the emergency department with headache, retro-orbital pain, and diplopia when gazing to the right. He had visited an urgent care clinic with right ear pain two weeks earlier and had received ... Read more
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Updated February 27, 2019 by Figure 1
Case Details A 9-year-old girl is brought to a new pediatrician by her mother over concerns regarding her weight. She has a history of developmental delay, and her mother mentions that she is noticeably shorter ... Read more
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Updated February 27, 2019 by Figure 1
A 37-year-old female presents to her family physician with recurring abdominal and flank pain. She mentions her mother suffered from kidney problems but doesn’t know many details. Examination reveals a blood pressure of 170/110 mmHg ... Read more
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Updated February 27, 2019 by Figure 1