Gambits

Cardiovascular Sys Internal medicine Pattern recognition good Interpretation of clinical vignette. UWORLD

Edema and Ascites After Prior Cardiac Surgery.

A 64-year-old man with diet-controlled type 2 diabetes and mitral valve repair 12 years ago presents with lower extremity edema and worsening abdominal discomfort. He has smoked a pack of cigarettes daily for 40 years. B...

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Cardiovascular Sys Internal medicine Life-threatening emergency good Interpretation of clinical vignette. UWORLD

Severe Chest Pain Radiating to the Back.

A 70-year-old man with a 20-year history of hypertension and type 2 diabetes presents with 3 hours of severe, sharp, constant chest and neck pain radiating to the interscapular region, unlike any pain he has had before....

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Cardiovascular Sys Surgery General principles of medicine Life-threatening emergency Differential diagnosis (DDX) UWORLD

Hemodynamic Unstable Male Patient with Flank Pain

A 72-year-old man is brought to the emergency department by ambulance with a 90-minute history of sudden, severe right-sided flank pain radiating to his back, accompanied by nausea. He briefly lost consciousness while wa...

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Cardiovascular Sys Internal medicine Diagnosis and management General principles of medicine UWORLD

Aching Pain with Dryness and Discoloration in Lower Limbs

A 61-year-old woman presents to establish primary care after not seeing a doctor for 12 years. She reports ongoing itching and dryness of both lower legs, along with a heavy, aching feeling that becomes worse toward the...

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Cardiovascular Sys Internal medicine Diagnosis and management General principles of medicine UWORLD

Female Patient with Palpitation and Heat Intolerance

A 36-year-old woman presents to the emergency department with a 4-hour history of palpitations, described as a rapid, irregular heartbeat. Over the past 3 months, she has experienced progressive anxiety, fatigue, heat in...

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Cardiovascular Sys Internal medicine General principles of medicine Differential diagnosis (DDX) Pattern recognition UWORLD

Palpitations With an Irregular Pulse

A 50-year-old man presents to the clinic with a 2-week history of palpitations. He denies chest pain, dyspnea, or diaphoresis. His medical history is significant for hypertension and type 2 diabetes mellitus. His blood p...

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Cardiovascular Sys Internal medicine General principles of medicine Life-threatening emergency UWORLD

Hypotension After Sublingual Nitroglycerin

A 54-year-old man with hypertension, type 2 diabetes mellitus, and hyperlipidemia is brought to the emergency department with a 90-minute history of substernal chest pressure accompanied by nausea and diaphoresis. He has...

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Cardiovascular Sys Internal medicine Diagnosis of Dz Life-threatening emergency Differential diagnosis (DDX) good Interpretation of clinical vignette. UWORLD

left-sided chest pain with dilated pupils!

A 29-year-old man is brought to the emergency department 40 minutes after the sudden onset of severe left-sided chest pain. He is anxious and agitated and cannot lie still. He has no known medical conditions and takes no...

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Cardiovascular Sys Internal medicine Diagnosis of Dz Solid memorization good Interpretation of clinical vignette. UWORLD

Claudication: Is Your Leg Really the Biggest Worry?

A 66-year-old man comes to the clinic because of cramping pain in his right calf and thigh when he walks about 2 blocks. The pain resolves within a few minutes of rest. He has no rest pain, foot ulcers, or color changes....

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Cardiovascular Sys Internal medicine Differential diagnosis (DDX) Pathophysiology UWORLD

Presyncope With Bradyarrhythmia in an Elderly Patient

A 77-year-old man presents to the clinic with an 8-month history of progressive fatigue and exertional dyspnea, occasional brief palpitations, and recent episodes of lightheadedness, including one occurring at rest. His...

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Cardiovascular Sys Internal medicine General principles of medicine good Interpretation of clinical vignette. UWORLD

Mortality-Reducing Drug in Post-MI Heart Failure

In a large randomized clinical trial, patients enrolled 3–14 days after an acute myocardial infarction complicated by heart failure (mean left ventricular ejection fraction, 30%) received either a study drug or placebo....

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Cardiovascular Sys Internal medicine Pattern recognition good Interpretation of clinical vignette. UWORLD

murmur found in the physical examination before a college

A 19-year-old woman comes to the office for a pre-participation physical before starting a college fitness class. She has noticed mild shortness of breath when climbing stairs for the past year but has had no chest pain,...

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Cardiovascular Sys Internal medicine Diagnosis and management Pathophysiology good Interpretation of clinical vignette. UWORLD

A Erectile Dysfunction With a Hidden Cause!

A 58-year-old man comes to the office because of erectile dysfunction. Over the past year he has had progressive difficulty achieving and maintaining an erection, although his libido is unchanged and he still has morning...

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Cardiovascular Sys Surgery Diagnosis and management Life-threatening emergency Pattern recognition good Interpretation of clinical vignette. UWORLD

He Survived the Fall, but His Legs Feel Cold!!

A 48-year-old man is brought to the emergency department after falling from a ladder onto concrete from a height of about 7 meters (23 ft) while cleaning a gutter. He has severe chest and back pain. Blood pressure is 168...

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Cardiovascular Sys Internal medicine General principles of medicine UWORLD

a drug that kills two birds with one stone.

A 62-year-old woman follows up for elevated blood pressure. One month ago, her office reading was 152/92 mm Hg; home monitoring since then shows an average of 148/88 mm Hg. Her only other condition is osteoporosis, diagn...

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Cardiovascular Sys Internal medicine Differential diagnosis (DDX) Solid memorization good Interpretation of clinical vignette. UWORLD

Progressive Edema with Preserved Ejection Fraction.

An 80-year-old woman presents with 2 months of progressive lower extremity edema, fatigue, exertional dyspnea, early satiety, and decreased appetite. Blood pressure is 136/75 mm Hg, pulse 70/min regular. Jugular veins ar...

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Gastrointestinal Sys Surgery Pattern recognition UWORLD

4-hour old boy with an abdominal mass.

A 4-hour-old boy is evaluated in the nursery for routine newborn care. He was born at 38 weeks' gestation by spontaneous vaginal delivery to an 18-year-old woman who received no prenatal care. Birth weight is 3.6 kg (8 l...

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Cardiovascular Sys Internal medicine Diagnosis of Dz Pathophysiology UWORLD

fatigue, SOB, and swelling in the legs, what is the diagnosis?

A 29-year-old woman comes to the office because of fatigue, worsening shortness of breath, and swelling of both feet for the past 5 days. She now becomes breathless climbing one flight of stairs and has needed extra pill...

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Gastrointestinal Sys Surgery good Interpretation of clinical vignette. UWORLD

Post-op fever and hiccups !

A 54-year-old woman comes to the ED with 2 days of abdominal pain, anorexia, nausea, hiccups, and shortness of breath. She underwent laparoscopic appendectomy for acute appendicitis 10 days ago and was recovering well un...

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Cardiovascular Sys Pediatric Diagnosis of Dz good Interpretation of clinical vignette. UWORLD

A child with difficult breathing

A 3-year-old girl is brought to the emergency department because of difficulty breathing. For the past 4 days she has had rhinorrhea, nasal congestion, and low-grade fever. Today she is tired and breathing fast, has refu...

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