eMedicine CME Case Presentations Index

 
 

eMedicine CME Case Presentations presents a new case each week.
For information on submitting a case, visit Case of the Week Submissions.

  • CME A 34-Year-Old Pregnant Woman with Acute Severe Abdominal Pain A 34-year-old woman presents to the ED with a 2-hour history of severe abdominal pain, 2 episodes of light-headedness, and loss of consciousness. She is about 6 weeks pregnant; the pain started suddenly the morning of presentation. What is the diagnosis?
    eMedicine Case Presentations, August 2008
  • CME/CE Hyperemesis and Epigastric Pain in a 27-Year-Old Man A 27-year-old man presents to the ED with a 2-day history of hyperemesis with hematemesis. The patient drank 21 cans of beer 3 days ago; his history reveals that he has vomited 30 times in the past 24 hours. What is the underlying etiology?
    eMedicine Case Presentations, August 2008
  • CME/CE An 8-Day-Old Boy With Tachypnea and Difficulty Feeding An 8-day-old boy is brought to the ED by his parents for a rapid breathing rate and decreased feeding. His vital signs are significant for a respiratory rate of 70 breaths/min and a heart rate of 296 bpm. What is shown on the EKG?
    eMedicine Case Presentations, July 2008
  • CME Left Lower Quadrant Abdominal Pain in a 60-Year-Old Man A 60-year-old man presents to the ED with a 1-day history of left-sided abdominal pain. The abdominal exam reveals tenderness and guarding; the digital rectal exam shows tenderness on the left side of the rectal vault. What is the diagnosis?
    eMedicine Case Presentations, July 2008
  • CME/CE A Cryptic Reason for Shortness of Breath in a Young Man A 24-year-old man with Down syndrome presents to the ED with a history of flank pain, hematuria, and shortness of breath. He has a history of bilateral cryptorchidism that was corrected. What is the diagnosis?
    eMedicine Case Presentations, July 2008
  • CME A 49-Year-Old Man With a Femur Fracture and Hyperdense Bones A 49-year-old man presents to the ED with pain after a fall onto the site of a previous complicated right femoral fracture. Severe limitation in knee flexion, muscle stiffness, and atrophy are noted. What is the underlying diagnosis?
    eMedicine Case Presentations, July 2008
  • CME A 48-Year-Old Man With Penile Trauma and Hematuria A 48-year-old man suffered a direct blow to his perineum and penis. No damage was initially noted; however, when urinating later, the patient experienced severe pain in his penis and noted a large amount of hematuria. What is the diagnosis?
    eMedicine Case Presentations, July 2008
  • CME Palpitations in a 19-Year-Old Male With a Rash A man presents to the ED in Connecticut after recurrent episodes of palpitations, fatigue, and syncope. Multiple, bilateral macular erythematous lesions with central pallor are noted on his thighs. What is the underlying etiology?
    eMedicine Case Presentations, June 2008
  • CME Syncope in an Otherwise Healthy Man A 30-year-old man presents to the ED after experiencing a syncopal event. He has had several such episodes in the past several years, but he has never sought medical evaluation for them. What is the patient's underlying disorder?
    eMedicine Case Presentations, June 2008
  • CME/CE Colicky Abdominal Pain and Bloody Diarrhea in a 57-Year-Old Woman A 57-year-old woman presents to the ED with a 3-day history of colicky lower abdominal pain and diarrhea. She has had intermittent episodes of bloody diarrhea over the past several months. The patient’s abdomen is mildly distended, and positive bowel sounds are observed. An abdominal contrast-enhanced computed tomography (CT) scan is performed because of a high suspicion of intra-abdominal pathology. What is the diagnosis?
    eMedicine Case Presentations, June 2008
  • CME A Diver Unconscious at the Surface After a Recreational Dive A 22-year-old recreational diver was performing an open-ocean dive and lost consciousness while ascending. Emergency measures were performed and the diver regained consciousness; within about 30 seconds, he began coughing pink, frothy sputum. The diver was taken to the ED. Auscultation of the left lower lung field revealed diminished breath sounds, and a CT scan of his chest was obtained. What was the cause of the loss of consciousness during the diver’s ascent?
    eMedicine Case Presentations, June 2008
  • CME/CE A Puzzling Facial Rash on a 17-Year-Old Boy A 17-year-old boy presents to the pediatric infectious disease clinic with a 10-day history of a facial rash. The rash began as several pimples over the forehead and cheek that spread to most of the right side of his face. The lesions are not itchy, but they are painful. No improvement was noted with 2 separate courses of antibiotic therapy. The patient is very active on his school wrestling team, and he was happily preparing for an upcoming competition. What is the most likely diagnosis?
    eMedicine Case Presentations, May 2008
  • CME/CE Ear Pain and a Rash in a 24-Year Old Man A 24-year-old man with HIV presents to the ED with intensifying left ear pain, swelling, and dizziness. His hearing in his left ear is muffled compared to that in his right ear. There is no history of trauma or allergic reactions, and the patient does not take any medications. The physical examination is notable for an obviously erythematous and edematous left ear, as well as a subtle left facial droop and weakness. What is the diagnosis?
    eMedicine Case Presentations, May 2008
  • CME/CE Recurrent Bacteremia in a 73-Year-Old Woman An elderly woman presents to the ED with fever, chills, and night sweats. The patient was recently hospitalized for hematochezia and fever; blood and urine cultures at that time showed evidence of bacteremia, and she was therefore treated with a course of levofloxacin. Over the past 24 hours, the fever and chills have returned. Her past medical history includes aortobifemoral bypass graft surgery and coronary artery bypass graft surgery. What is the diagnosis?
    eMedicine Case Presentations, May 2008
  • CME/CE Back Pain in a 39-Year-Old Man from Guatemala A 39-year-old Guatemalan man presents to the ED with severe and debilitating back pain. He has been previously evaluated for his back pain twice in the past few weeks. The pain is throbbing and diffuse throughout the lower back, with radiation to his left buttock and upper back, and it has been progressively worsening. Mild tenderness to palpation is noted in the midline lower back. A lumbar radiograph and a magnetic resonance imaging scan of the spine are obtained. What is the diagnosis?
    eMedicine Case Presentations, May 2008
  • CME A 33-year-old Woman with Sudden-Onset Severe Headache and Vomiting A 33-year-old woman presents to the ED with a severe headache, associated vomiting, blurred vision, and weakness in her left leg. She states that it is the worst headache of her life, and it is worsening despite her use of acetaminophen. She has a 4-year history of oral contraceptive use. Her pupils show a slightly sluggish reaction to light, and bilateral papilledema is noted on the funduscopic examination. A magnetic resonance venogram (MRV) is taken. What is the diagnosis?
    eMedicine Case Presentations, May 2008
  • CME A Young Woman with General Malaise and a Persistent Fever A 21-year-old woman presents to the ED with a history of fever, general malaise, mild diffuse cramping and abdominal pain, and a cough with occasional blood-tinged sputum. She was recently diagnosed with HIV/AIDS, but she is not currently on antiretroviral medications. The patient appears cachectic and fatigued, and she is noted to be tachycardic, febrile, and has mild tachypnea. Diagnostic laboratory studies are conducted, and a chest radiograph and CT scan are taken. What is the diagnosis?
    eMedicine Case Presentations, April 2008
  • CME Dyspnea Following Initial Scuba Diving Training A 27-year-old man presents with progressive dyspnea following an initial scuba-diving training session. Approximately 1 hour into the dive, he began to feel mild chest tightness directly under his breastbone; this progressed to difficulty breathing with a frequent, nonproductive cough over the following 8 hours. The patient had accidentally held his breath as he ascended from a depth of approximately 12 ft to a depth of 10 ft in a swimming pool. What is the cause of this patient’s dyspnea?
    eMedicine Case Presentations, April 2008
  • CME A Traveler’s Fever A 17-year-old man presents to the ED with a 2-day history of headache, fever, and intermittent sweats. The patient recently returned from a 3-week trip to Nigeria. According to the patient, he felt well when he initially returned; however, today he has developed a worsening headache, bilious emesis, palpitations, and sweats. A blood smear is obtained. What is the diagnosis?
    eMedicine Case Presentations, April 2008
  • CME An Atypical Cause of Gastrointestinal Bleeding A 53-year-old man with multiple myeloma presents with a 1-week history of melena, hematemesis, and lethargy. He has no other significant past medical history, and he has not needed chemotherapy to date. The patient does not describe any symptoms suggestive of active multiple myeloma and organ involvement. He is treated with IV fluid and 2 units of blood. An esophagogastroduodenoscopy is performed. What is the cause of the abnormalities seen on the endoscopy?
    eMedicine Case Presentations, April 2008
 
 
 
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