A 68 yo male presents with jaundice, weight loss, and boring abdominal pain which radiates to the back. The gallbladder is palpable with a positive Courvoisier’s sign. What is the most likely diagnosis?
A patient with a history of chronic lower extremity venous insufficiency presents for routine follow up. What would be the most likely physical findings upon examination?
A 32 yo male presents with an 1 month history of weakness, anorexia, and weight loss. On exam he is hypotensive and his skin has diffuse hypopigmentation. Plasma cortisol levels drawn at 8AM are low. Which is the most likely diagnosis?
A 72 yo female presents to clinic c/o constipation. Upon examination and questioning you reveal over the last 6 months she has had marked weight loss, anemia, hematochezia, and today is postive for fecal occult blood test. What is your likely diagnosis that must be ruled out with what diagnostic test.
A 75 yo male presents with a history of coronary artery disease and dyslipidemia. Exam reveals loss of hair on the lower extremities bilaterally with thinning of the skin. Femoral pulses are 2/4 bilaterally, pedal pulses are diminished. Anke brachial index is reduced. What is your diagnosis and what symptom would you expect with walking.
What is the typical patient history consistent with Rheumatoid Arthritis? Include onset, AM symptoms, joint symptoms, and symmetry.
A 23 month old presents in the ED with acute onset of severe pharyngitis, fever of 103.5 F and what sounds like harsh, high-pitched breath sounds. The child is drooling and seems to clinically be rapidly worsening. The child has not been immunized due to religious reasons. What is the most likely diagnosis and what is the most appropriate emergent treatment
Question 1
68 years male
Answer: cholecystitis
Question 2
Venous insufficiency
Answer: edema and impaired skin integrity.
Question 3
32 years patient
Answer: Addison's disease.
Question 4
72 years female
Answer: colon cancer.
Question 5
23 months old
Answer: Diphtheria
A 68 yo male presents with jaundice, weight loss, and boring abdominal pain which radiates to...
Bony and cartilaginous enlargement of distal interphalangeal joints is commonly seen in what condition and what are these enlargements called? A 75 yo female presents with a history of Hypertension and now has shortness of breath. On exam, you notice a diastolic murmur at the left sternal border. What exam maneuvers would accentuate this murmur and what is your diagnosis? A 45 yo female presents complaining of the absolute worst headache of her life. What is your initial clinical diagnosis...
A 44 yo female hairdresser presents with a 2 month history of pain and numbness of her left hand that awakens her from sleep. On exam, you reveal electric tingling sensations with percussion over the volar surface of the wrist and paresthesias within 15 seconds of passively flexing the wrist. What is the most likely diagnosis and what is the initial noninvasive treatment of choice to maintain a neutral position of the wrist? A 34 yo male presents with fever...
A 33 yo male presents with a right knee injury associated with pain and swelling. He was running and suddenly stopped, hyperextended his knee, heard a pop and noticed immediate swelling. On exam, the Lachman test and anterior drawer test demonstrates joint laxity. What is your diagnosis? A 22 yo female presents with cola colored urine and has not urinated in the last 24 hours. She recently was diagnosed with pharyngitis 2 weeks ago. On exam, she has edema of...
A 23 yo male presents with chest pain. His pain is worse lying down and better sitting up and leaning forward. EKG shows widespread ST segment elevation. What is your diagnosis and what exam finding would you expect upon examination? A 75 yo female presents with sudden vision loss. Exam reveals a palpable cord in the temporal region. What is your diagnosis and what would be the best initial test to confirm your diagnosis? A 53 yo male presents with...
Hypoglycemia in an elderly patient with diabetes is most likely to manifest as what symptom? A 43 yo woman presents with episodes of facial flushing with increased skin temperature followed by the development of tiny papules and pustules primarily on her cheeks and chin. The symptoms worsen with spicy foods and alcohol consumption. What is the likely diagnosis? A 25yo female presents for routine GYN examination. A 2cm mass is palpated in her right breast. Her LMP was 2 weeks...
A 41 yo male with a history of IV drug abuse presents with acute, nontraumatic right knee pain, chills, and sweats starting 2 days ago. On exam, his temperature is 102.9 F, the right knee is erthematous, edematous, tender to palpation, and also decreased range of motion. Plain X-rays of knee show soft tissue swelling. What is your most likely diagnosis? A 52 yo female is diagnosed with chronic myeloid leukemia (CML). What would you expect to find on your...
On physical exam of a pregnant patient, what is a normal finding with cardiac auscultation? A 58 yo female presents with a white spot on her tongue. She has a 42 pack year smoking history. On exam,, she has an 8 mm white, thickened, keratinized lesion on the ventral tongue. The lesion cannot be removed by rubbing the mucosal surface. What is the most likely diagnosis of the white lesion and what test would you perform to confirm the diagnosis?...
A patient describes a history of intermittent and uncontrollable twitching of his right hand that spreads to involve the entire arm after a few minutes. Afterward, the arm is extremely weak. There are no other areas of involvement, sensory deficits or altered consciousness. What is the most likely seizure diagnosis? A 15 yo male presents with acute onset of nausea, severe pain and swelling of the right testis. He has no fever or irritative voiding symptoms. On exam, the right...
A 51-year-old male presents to your office with left lower abdominal pain, diarrhea, nausea, and vomiting. He states that he has a decreased appetite along with a low-grade fever and chills. His past medical history includes a diagnosis of hypertension and obesity. He is a smoker. Upon arrival, his vital signs are normal aside from a pulse of 102 and a temperature of 100.0. On exam you note the patient is visibly uncomfortable. When you exam his abdomen, you note...
Chief Complaint A 24 y.o. male presents for a pre-employment physical and mentions a rash on his chest. He noticed the rash last night and says it is “very itchy.” He has not noticed any other skin changes. Overall, he feels well without any accompanying symptoms. He is a teacher and spent most of last weekend doing yard work. Past Medical History • Allergic rhinitis, uses over-the-counter antihistamines • Denies surgeries or serious illnesses/hospitalizations Family History • Father, hypertension •...