Internet cool tools for physicians By Melissa L. Rethlefsen, David L. Rothman, Daniel Stéphane Mojon:
Some Blogs We Like: "Clinical Cases and Images – Blog (http:// casesblog.blogspot.com/) – This consistently interesting blog written by Dr. Ves Dimov features case histories, medical news, images, and useful practical technology tips."
Healthcare and the Effect of Technology: Developments, Challenges. Stefane M. Kabene - 2010:
"Giustini (2007) provided a summary of useful Web 2.0 applications in medicine (eg, Ves Dimov's Clinical Cases and Images Blog; Ask Dr. Wiki; Ganfyd."
New Directions in Intelligent Interactive Multimedia - Page 517 George A. Tsihrintzis, Maria Virvou, Robert J. Howlett - 2008.
Computational Intelligence in Healthcare 4: Advanced Methodologies - Page 319 Isabelle Bichindaritz, Lakhmi C. Jain, Sachin Vaidya - 2010.
Medical librarian 2.0: use of Web 2.0 technologies in reference. M. Sandra Wood - 2007.
Social Media Marketing All-in-One For Dummies - Page 76 Jan Zimmerman, Doug Shalin.
Ubiquitous Health and Medical Informatics: The Ubiquity 2.0 Trend and Beyond. Sabah Mohammed, Jinan Fiaidhi - 2010.
The Hospitalist Manual - Page 308 - Manish Mehta, Arun Thomas Mathews - 2009.
Showing posts with label Clinical Cases. Show all posts
Showing posts with label Clinical Cases. Show all posts
Monday, April 25, 2011
Monday, May 18, 2009
Case of the Week: Anemia with Hemoglobin 4.2 mg/dL. What is the Cause?
The Case of the Week series features a different article from Clinical Cases and Images each week:A 51-year-old female has had fatigue, weakness, and SOB with exertion during the past 4-5 days. She called her PCP who recommended she had hemoglobin checked. He called her back with the results, and told her to go to the ER for further treatment of severe anemia.
Physical examination
VS: mild tachycardia, no hypotension.
General appearance: pale, non-icteric. The rest of the exam was unremarkable.
Laboratory results
CBC and CMP
What is the most likely diagnosis?
Severe anemia that is symptomatic with fatigue and shortness of breath (SOB).
What are the likely causes of anemia in this patient?
Blood loss?
Hemolytic anemia?
Iron-deficiency?
What laboratory workup would you order? Would you transfuse this patient? How would you treat this patient?
Read the rest of the case here: Hemoglobin 4.2 mg/dL due to Autoimmune Hemolytic Anemia from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Image source: Structure of human hemoglobin, Wikipedia, GNU Free Documentation License.
Monday, March 9, 2009
Case of the Week: Headache and Jaw Pain in an Elderly Patient
The Case of the Week series features a different article from Clinical Cases and Images each week:
A 75-year-old African American female started to complain of occasional jaw pain 4 months ago. She also began complaining of headache 3 weeks ago.
Physical examination
HEENT: NC/AT, temporal arteries palpable, slightly painful on the right.
Outline of side of face, showing the main surface markings. The superficial temporal artery is visible at center, to the left of the ear. Image source: Gray's Anatomy, public domain.
What is the most likely cause of this patient's symptoms?
Tension headache.
Headache due to cervical spondylosis.
Headache due to TMJ dysfunction.
Temporal arteritis.
Read the rest of the case here: Giant Cell Arteritis Presenting with Headache and Jaw Pain from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
A 75-year-old African American female started to complain of occasional jaw pain 4 months ago. She also began complaining of headache 3 weeks ago.
Physical examination
HEENT: NC/AT, temporal arteries palpable, slightly painful on the right.
Outline of side of face, showing the main surface markings. The superficial temporal artery is visible at center, to the left of the ear. Image source: Gray's Anatomy, public domain.
What is the most likely cause of this patient's symptoms?
Tension headache.
Headache due to cervical spondylosis.
Headache due to TMJ dysfunction.
Temporal arteritis.
Read the rest of the case here: Giant Cell Arteritis Presenting with Headache and Jaw Pain from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, February 9, 2009
Case of the Week: Finger Clubbing
The Case of the Week series features a different article from Clinical Cases and Images each week:
A 56-year-old African American male (AAM) was seen in the ER for bronchitis a year ago. The CXR showed a right upper lobe (RUL) mass, and the patient was told to follow-up with his physician but he never did.
Finger clubbing in a long-term smoker with a suspected lung cancer.
CBC, CMP.
A PA CXR showed a small RUL mass a year ago.
The RUL mass seen on the previous CXR a year ago has increased in size.
What is the most likely cause of this patient's symptoms?
Read more about the Schamroth sign that is named not only after a physician who described it but also after the patient who happened to be the physician himself.
Read the rest of the case here: Finger Clubbing due to Lung Cancer from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
A 56-year-old African American male (AAM) was seen in the ER for bronchitis a year ago. The CXR showed a right upper lobe (RUL) mass, and the patient was told to follow-up with his physician but he never did.
Finger clubbing in a long-term smoker with a suspected lung cancer.
CBC, CMP.
A PA CXR showed a small RUL mass a year ago.
The RUL mass seen on the previous CXR a year ago has increased in size.
What is the most likely cause of this patient's symptoms?
Read more about the Schamroth sign that is named not only after a physician who described it but also after the patient who happened to be the physician himself.
Read the rest of the case here: Finger Clubbing due to Lung Cancer from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, February 2, 2009
Case of the Week: Diagnosing Anemia
The Case of the Week series features a different article from Clinical Cases and Images each week:
A 58-year-old AAM was admitted from a nursing home with a chief complaint of lethargy and acting inappropriately.
Laboratory results
CBC (left, click to enlarge the image); CMP; CBCD, iron profile and prealbumin.
What is the most likely cause of this patient's anemia?
Read the rest of the case here: Anemia due to Iron Deficiency and Chronic Disease from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
A 58-year-old AAM was admitted from a nursing home with a chief complaint of lethargy and acting inappropriately.
Laboratory results
CBC (left, click to enlarge the image); CMP; CBCD, iron profile and prealbumin.
What is the most likely cause of this patient's anemia?
Read the rest of the case here: Anemia due to Iron Deficiency and Chronic Disease from Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, January 19, 2009
Images in Medicine: Visualising Rhabdomyolysis
From The Lancet:
"A haemodialysis patient with hypercholesterolaemia was admitted with an ulcer on his left foot. Shortly after admission he complained of generalised aching and difficulty in mobilising.
Osteomyelitis complicating his foot ulcer was suspected and a Tc 99 -labelled diphosphonate bone scan was done. The scan showed uptake into damaged muscle"
Click here to see the images from The Lancet website.
Model of helical domains in myoglobin, the protein linked to kidney damage in rhabdomyolysis. Image source: Wikipedia, public domain.
Rhabdomyolysis is the rapid breakdown (lysis) of skeletal muscle tissue (rhabdomyo) due to injury to muscle tissue. Rhabdomyolysis and its complications are major problems in people who are injured in disasters such as earthquakes and bombing. The disease and its mechanisms were first elucidated in the Blitz of London in 1941.
References:
Visualising rhabdomyolysis. Stephen Walsh et al. The Lancet, Volume 373, Issue 9658, Page 154, 10 January 2009.
Rhabdomyolysis, from Wikipedia, the free encyclopedia.
Related:
Rhabdomyolysis Review, Hospital Physician, 2009 (PDF).
Updated: 05/14/2009
"A haemodialysis patient with hypercholesterolaemia was admitted with an ulcer on his left foot. Shortly after admission he complained of generalised aching and difficulty in mobilising.
Osteomyelitis complicating his foot ulcer was suspected and a Tc 99 -labelled diphosphonate bone scan was done. The scan showed uptake into damaged muscle"
Click here to see the images from The Lancet website.
Model of helical domains in myoglobin, the protein linked to kidney damage in rhabdomyolysis. Image source: Wikipedia, public domain.
Rhabdomyolysis is the rapid breakdown (lysis) of skeletal muscle tissue (rhabdomyo) due to injury to muscle tissue. Rhabdomyolysis and its complications are major problems in people who are injured in disasters such as earthquakes and bombing. The disease and its mechanisms were first elucidated in the Blitz of London in 1941.
References:
Visualising rhabdomyolysis. Stephen Walsh et al. The Lancet, Volume 373, Issue 9658, Page 154, 10 January 2009.
Rhabdomyolysis, from Wikipedia, the free encyclopedia.
Related:
Rhabdomyolysis Review, Hospital Physician, 2009 (PDF).
Updated: 05/14/2009
Thursday, January 8, 2009
Case of the Week: Febrile Neutropenia After Chemotherapy
The Case of the Week series features a different article from Clinical Cases and Images each week:A 55-year-old CM is admitted to the hospital with fever for one day. He has a history of unresectable lung cancer (NSCLC) and has completed 6 chemotherapy courses with carboplatin and doxorubicin.
Laboratory results
CBCD and CMP (click to enlarge the images).
WBC is only 1,000 with ANC of 260/mm3.
What would you do next?
Read more here: Febrile Neutropenia in a Patient on Chemotherapy from Clinical Cases and Images.
The image in the upper right corner shows a neutrophil. Source: Wikipedia, GNU Free Documentation License.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, December 29, 2008
Case of the Week: Constipation and Uncontrolled Hypothyroidism
The Case of the Week series features a different article from Clinical Cases and Images each week:Constipation as a Chief Complaint of Uncontrolled Hypothyroidism
A 61-year-old AAF was admitted to the hospital with a chief complaint of bilateral knee pain for 2 weeks. She was diagnosed with severe osteoarthritis (OA) and opioid pain medications were started. The patient's last bowel movement was one week prior to admission and she did not have any BM after that despite multiple laxatives.
Laboratory results
TSH was 41.40 mU/L.
What happened next?
Read more at Clinical Cases and Images.
The image in the upper right corner shows thyroid histology. Source: Wikipedia, public domain.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Image source: Thyroid histology, Wikipedia, public domain.
Tuesday, December 16, 2008
Case of the Week: Constipation, Iron Deficiency Anemia and Positive Fecal Occult Blood. Is it Colon Cancer?
The Case of the Week series features a different article from Clinical Cases and Images each week:
Constipation, Iron Deficiency Anemia and Positive Fecal Occult Blood. Is it Colon Cancer? Not So Fast
A 73-year-old Caucasian male (CM) who was never followed by a doctor is admitted to the hospital with chief complaints (CC) of constipation, profound weakness and exertional chest pain.
CBC showed anemia with hemoglobin (Hgb) 5.7 mg/dL. His EGD and Colonoscopy are shown below.
EGD
Colonoscopy
What is the most likely diagnosis?
Read more at Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Constipation, Iron Deficiency Anemia and Positive Fecal Occult Blood. Is it Colon Cancer? Not So Fast
A 73-year-old Caucasian male (CM) who was never followed by a doctor is admitted to the hospital with chief complaints (CC) of constipation, profound weakness and exertional chest pain.
CBC showed anemia with hemoglobin (Hgb) 5.7 mg/dL. His EGD and Colonoscopy are shown below.
EGD
Colonoscopy
What is the most likely diagnosis?
Read more at Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, December 8, 2008
Case of the Week: Bloody Ascites and Gas Under the Diaphragm
The Case of the Week series features a different article from Clinical Cases and Images each week:
Bloody Ascites and Gas Under the Diaphragm
A 39 yo African American male (AAM) with a history of new onset ascites 1 week ago, cirrhosis, and end stage renal disease on hemodialysis (ESRD on HD) is admitted to the hospital from the HD unit after he was found to have fever of 39 C.
A previous CXR from 5 days ago (left); the new CXR (middle); air/fluid level close-up (right) (click to enlarge the images).
He had an ultrasound (U/S) guided paracentesis during which 700 cc of bloody fluid were drained.
What is the cause of Bloody Ascites and Gas Under the Diaphragm?
Read more at Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Bloody Ascites and Gas Under the Diaphragm
A 39 yo African American male (AAM) with a history of new onset ascites 1 week ago, cirrhosis, and end stage renal disease on hemodialysis (ESRD on HD) is admitted to the hospital from the HD unit after he was found to have fever of 39 C.
A previous CXR from 5 days ago (left); the new CXR (middle); air/fluid level close-up (right) (click to enlarge the images).
He had an ultrasound (U/S) guided paracentesis during which 700 cc of bloody fluid were drained.
What is the cause of Bloody Ascites and Gas Under the Diaphragm?
Read more at Clinical Cases and Images.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, December 1, 2008
Case of the Week: Pneumonia and Metabolic Acidosis
The Case of the Week series features a different article from Clinical Cases and Images each week:
Pneumonia and Metabolic Acidosis in a 35-kilogram Man
A 71-year-old African American male (AAM) is admitted to the hospital with the chief complaint of shortness of breath (SOB) which has had become progressively worse during the last 4-5 days.
A previous CXR (6 months ago), left. Right-sided pneumonia, right.
ABG: 7.25-31-62-13
What is the most likely diagnosis?
Why does he have acidosis?
Read more in Pneumonia and Metabolic Acidosis in a 35-kilogram Man.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Pneumonia and Metabolic Acidosis in a 35-kilogram Man
A 71-year-old African American male (AAM) is admitted to the hospital with the chief complaint of shortness of breath (SOB) which has had become progressively worse during the last 4-5 days.
A previous CXR (6 months ago), left. Right-sided pneumonia, right.
ABG: 7.25-31-62-13
What is the most likely diagnosis?
Why does he have acidosis?
Read more in Pneumonia and Metabolic Acidosis in a 35-kilogram Man.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. You will be credited as an author with each case you submit.
References:
Starting "Case of the Week" Series in Response to Reader Requests. Clinical Cases and Images - Blog, Nov 2008.
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Monday, November 24, 2008
Starting "Case of the Week" Series in Response to Reader Requests
In most cases, your blog readers will tell what they need if you just listen to them. For example:
Anonymous said (partially edited for grammar):
"It's wonderful the effort you make in making doctors to be up-to-date with the technology, the suggestion I have for you though is, since a good number of your readers could be either residents or medical students like me, please could you also post some clinical scenarios that are dedicated towards solving clinical problems on a weekly basis, this is just my suggestion. Thank you"
My response was:
"Great idea. Will implement it -- "Case of the Week" should be available as a regular feature next month. Thank you for the suggestion."
The first case in the Case of the Week series is linked below:
Atrial fibrillation with rapid ventricular response due to central line placement
A young female with DM type 1 was admitted to the hospital with an infected right diabetic foot ulcer. She needed IV access and failed several peripheral line attempts. A right internal jugular central line was and she immediately complained of shortness of breath and palpitations.
What is the most likely diagnosis?
Triple lumen catheter (TLC) at the right atrio-ventricular (AV) junction on CXR.
Atrial fibrillation (AFib) with rapid ventricular response (RVR) due to a TLC at the right atrio-ventricular (AV) junction.
See what happened next in Atrial fibrillation (AFib) with rapid ventricular response (RVR) due to central line placement at Clinical Cases and Images.
What happened to the medical abbreviations?
We appreciate your feedback about using medical abbreviations. In the first edition of ClinicalCases.org, the goal was to make the cases as authentic as possible, therefore, we used abbreviations liberally throughout the text, for example, "55 yo AAF w PMH of CHF, COPD, CAD s/p MI is here for a c-scope." However, some abbreviations were confusing to many readers especially those based outside the U.S. For example, "GERD" (gastroesophageal reflux disease) is actually called "GORD" in some countries. We still feel there is a value in providing as many abbreviations as possible to acquaint the reader with what "the real medicine looks like." In response to readers, the new and revised cases at ClinicalCases.org (updated gradually) will explain the abbreviations in full text whenever they are used.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. The website will stay free and you are credited as an author with each case you submit.
References:
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Anonymous said (partially edited for grammar):
"It's wonderful the effort you make in making doctors to be up-to-date with the technology, the suggestion I have for you though is, since a good number of your readers could be either residents or medical students like me, please could you also post some clinical scenarios that are dedicated towards solving clinical problems on a weekly basis, this is just my suggestion. Thank you"
My response was:
"Great idea. Will implement it -- "Case of the Week" should be available as a regular feature next month. Thank you for the suggestion."
The first case in the Case of the Week series is linked below:
Atrial fibrillation with rapid ventricular response due to central line placement
A young female with DM type 1 was admitted to the hospital with an infected right diabetic foot ulcer. She needed IV access and failed several peripheral line attempts. A right internal jugular central line was and she immediately complained of shortness of breath and palpitations.
What is the most likely diagnosis?
Triple lumen catheter (TLC) at the right atrio-ventricular (AV) junction on CXR.
Atrial fibrillation (AFib) with rapid ventricular response (RVR) due to a TLC at the right atrio-ventricular (AV) junction.
See what happened next in Atrial fibrillation (AFib) with rapid ventricular response (RVR) due to central line placement at Clinical Cases and Images.
What happened to the medical abbreviations?
We appreciate your feedback about using medical abbreviations. In the first edition of ClinicalCases.org, the goal was to make the cases as authentic as possible, therefore, we used abbreviations liberally throughout the text, for example, "55 yo AAF w PMH of CHF, COPD, CAD s/p MI is here for a c-scope." However, some abbreviations were confusing to many readers especially those based outside the U.S. For example, "GERD" (gastroesophageal reflux disease) is actually called "GORD" in some countries. We still feel there is a value in providing as many abbreviations as possible to acquaint the reader with what "the real medicine looks like." In response to readers, the new and revised cases at ClinicalCases.org (updated gradually) will explain the abbreviations in full text whenever they are used.
Keep the feedback coming -- we are listening to you
You can use any comment section under any post or article to submit feedback. All comments are emailed to the editor immediately after you hit the "submit" button. Keep the feedback coming. We are listening to you and our goal is to make the Clinical Cases and Images as useful as possible to all readers around the world.
Submit your own case
Do not forget to use the online form to submit your own case for consideration and inclusion in this collaborative resource which has become the most popular free online case-based curriculum of clinical medicine. The website will stay free and you are credited as an author with each case you submit.
References:
Clinical Cases and Images: About Us.
Complete List of Medical Abbreviations and Acronyms.
Friday, September 26, 2008
What Treatment Devices Would You Recommend to a Patient with Asthma and Allergic Rhinitis Who Has Severe Arthritis and Stroke History?
A 58 yo male with asthma and allergic rhinitis reports difficulty using his asthma inhalers and nasal spray.
He has a history of DM2, allergic rhinitis, mild asthma, severe arthritis of the hands, and a R hand weakness secondary to remote stroke.
Medications:
Nasacort (triamcinolone), Albuterol MDI, glyburide, rosiglitazone
Physical examination:
HEENT: Pale boggy turbinates with 75% obstruction of the nasal cavity
Chest: CTA (B)
Extremities: severe arthritis of both hands, and a R hand weakness secondary to remote stroke.
A hand with arthritic changes. Image source: Cicadas, a Creative Commons license.
What would you recommend to this patient?
Read more in Treatment Devices for an Asthma and Allergic Rhinitis Patient with Arthritis and Stroke from AllergyCases.org.
He has a history of DM2, allergic rhinitis, mild asthma, severe arthritis of the hands, and a R hand weakness secondary to remote stroke.
Medications:
Nasacort (triamcinolone), Albuterol MDI, glyburide, rosiglitazone
Physical examination:
HEENT: Pale boggy turbinates with 75% obstruction of the nasal cavity
Chest: CTA (B)
Extremities: severe arthritis of both hands, and a R hand weakness secondary to remote stroke.
A hand with arthritic changes. Image source: Cicadas, a Creative Commons license.
What would you recommend to this patient?
Read more in Treatment Devices for an Asthma and Allergic Rhinitis Patient with Arthritis and Stroke from AllergyCases.org.
Monday, September 15, 2008
Clinical Case: Pituitary adenoma in a patient with systemic sarcoidosis
A 68 year-old female with a past medical history of diabetes mellitus, hypertension, remotely treated breast cancer and sarcoidosis presented with a 4-day history of rapidly progressive right frontal and periorbital headache, associated with right ptosis, diplopia and unsteady gait.
What is the reason for her symptoms?
Brain MRI with gadolinium: right parasellar mass extending into the cavernous sinus and Meckel’s cave without meningeal enhancement.
Brain MRA: anterior and inferior displacement of the right carotid artery (intracavernous portion).
Read more in Unsuspected Diagnosis Of Non-Functioning Pituitary Adenoma In A Patient With Multiorgan Involvement Sarcoidosis from Clinical Cases and Images.
The author of this clinical case is Moises Auron, M.D., a Staff Physician at the Department of Hospital Medicine at Cleveland Clinic.
What is the reason for her symptoms?
Brain MRI with gadolinium: right parasellar mass extending into the cavernous sinus and Meckel’s cave without meningeal enhancement.
Brain MRA: anterior and inferior displacement of the right carotid artery (intracavernous portion).
Read more in Unsuspected Diagnosis Of Non-Functioning Pituitary Adenoma In A Patient With Multiorgan Involvement Sarcoidosis from Clinical Cases and Images.
The author of this clinical case is Moises Auron, M.D., a Staff Physician at the Department of Hospital Medicine at Cleveland Clinic.
Wednesday, September 10, 2008
Clinical Case: Eosinophilc Eosophagitis
An 8-year-old boy complains of abdominal pain, nausea, vomiting, lack of appetite and weight loss for 6 months. Past medical history includes allergic rhinitis and conjunctivitis and skin prick testing positive for house dust mite.
What would you next?
Read the rest of the case here: Right Lower Quadrant Pain due to Eosinophilc Eosophagitis from AllergyCases.org.
"Multi-ring esophagus" in eosinophilic esophagitis (left), infiltration of eosinophils (right). Source: Wikipedia.
Eosinophilic Esophagitis, mind map diagram.
Related:
Eosinophilic Esophagitis: A Short Review
Mind Maps: Eosinophilic Esophagitis
Mnemonics: Eosinophilic Esophagitis
Eosinophilic Esophagitis videocast from The DAVE Project - Gastroenterology, 2005.
NEJM Images: Adult-Onset Eosinophilic Esophagitis. Clinical Cases and Images - Blog.
What would you next?
Read the rest of the case here: Right Lower Quadrant Pain due to Eosinophilc Eosophagitis from AllergyCases.org.
"Multi-ring esophagus" in eosinophilic esophagitis (left), infiltration of eosinophils (right). Source: Wikipedia.
Eosinophilic Esophagitis, mind map diagram.
Related:
Eosinophilic Esophagitis: A Short Review
Mind Maps: Eosinophilic Esophagitis
Mnemonics: Eosinophilic Esophagitis
Eosinophilic Esophagitis videocast from The DAVE Project - Gastroenterology, 2005.
NEJM Images: Adult-Onset Eosinophilic Esophagitis. Clinical Cases and Images - Blog.
Thursday, August 28, 2008
ClinicalCases.org used to teach ICU topics to residents
One of the latest applications of our free case-based curriculum of clinical medicine, ClinicalCases.org, was in the teaching of the residents at Moses Cone Family Medicine Residency.
The faculty used the following cases for review of Acute Respiratory Failure:
Clinical Cases and Images: Atelectasis due to Hypoventilation and Mucus Plug
Clinical Cases and Images: Weaning & Extubation Criteria in a Patient with Septic Shock and Respiratory Failure
Respiratory Depression in COPD Patient
COPD vs. CHF Exacerbation
Respiratory Arrest
Moses Cone Family Medicine Residency: ICU Goals, Objectives & Resources.
Where is Moses Cone Family Medicine Residency Program?
The Moses H. Cone Memorial Hospital is in Greensboro, North Carolina.
The faculty used the following cases for review of Acute Respiratory Failure:
Clinical Cases and Images: Atelectasis due to Hypoventilation and Mucus Plug
Clinical Cases and Images: Weaning & Extubation Criteria in a Patient with Septic Shock and Respiratory Failure
Respiratory Depression in COPD Patient
COPD vs. CHF Exacerbation
Respiratory Arrest
Moses Cone Family Medicine Residency: ICU Goals, Objectives & Resources.
Where is Moses Cone Family Medicine Residency Program?
The Moses H. Cone Memorial Hospital is in Greensboro, North Carolina.
Wednesday, August 27, 2008
Clinical Case: How to Diagnose Common Variable Immunodeficiency (CVID)?
A 65-year-old female has a history of frequent UTIs for the last year. Serum immunoglobulins showed low levels of IgG 515 mg/dL (reference range 700 to 1600), IgM 30 (reference range 40 to 230), IgA 50 (reference range 70 to 400).
What is the reason for the low levels of immunoglobulins?
Five immunoglobulin classes (mind map)
What is the diagnostic work-up for CVID?
What treatment options would you suggest?
Read the rest of the case here: How to Diagnose Common Variable Immunodeficiency (CVID)? from AllergyCases.org.
What is the reason for the low levels of immunoglobulins?
Five immunoglobulin classes (mind map)
What is the diagnostic work-up for CVID?
What treatment options would you suggest?
Read the rest of the case here: How to Diagnose Common Variable Immunodeficiency (CVID)? from AllergyCases.org.
Thursday, August 21, 2008
Clinical Image: What is Bochdalek's Hernia?
In 1848, Bochdalek described the congenital defect in fusion of the posterolateral foramina of the diaphragm.
Bochdalek's hernia on the left
Bochdalek's hernia on the left
Most Bochdalek's hernias occur on the left side, allowing protrusion of the abdominal viscera into the chest. Previously unrecognized Bochdalek's hernia in adults is often diagnosed incidentally.
Read more here in Bochdalek's Hernia from Clinical Cases and Images.
Bochdalek's hernia on the left
Bochdalek's hernia on the left
Most Bochdalek's hernias occur on the left side, allowing protrusion of the abdominal viscera into the chest. Previously unrecognized Bochdalek's hernia in adults is often diagnosed incidentally.
Read more here in Bochdalek's Hernia from Clinical Cases and Images.
Monday, August 18, 2008
Case Presentations on YouTube
Internal medicine tutorial, case study 1
The YouTube user mhussam seems to be an Egyptian physician who has uploaded 9 case presentations.
This is an interesting proof of concept that may deserve further exploration.
Last year, we posted about a pathologist with the screen name of WashingtonDeceit who had uploaded 544 histopathology videos since he joined YouTube on February 03, 2007. The videos lasted between 2 and 5 minutes and were professionally made and narrated.
We asked the nephrology fellows at the Cleveland Clinic what they thought about the renal histopathology videos via an anonymous web-based survey (SurveyMonkey.com). They actually found them quite useful and the abstract was published in the supplement of the Journal of the American Society of Nephrology from the annual ASN meeting (Renal Week 2007).
Histopathology Kidney -- Interstitial nephritis
References:
544 Histopathology Videos on YouTube
YouTube as a source of information on immunization: a content analysis. Keelan et al. JAMA. 2007 Dec 5;298(21):2482-4.
Friday, August 8, 2008
Clinical Case: How to Treat an Exacerbation of Atopic Dermatitis?
An 18-month old boy is here for a follow-up of atopic dermatitis. He was last seen at the clinic 3 months ago and at that time his mother described his symptoms as "8" - the lesions were affecting his face, elbows, the areas behind the ears and knees, and the pubis. He was prescribed Elidel (pimecrolimus) and hydrocortisone 1% for the face BID, and Elidel and triamcinolone 0.1% (Kenalog) for the body BID. The symptoms improved significantly and the mother downshifted local therapy to triamcinolone 0.1% daily a month ago. She also stopped Singulair. Two weeks ago, the skin lesions re-occurred, including new ones on the face and back.What treatment options would you suggest?
Read the rest of the case here: Treatment of Exacerbation of Moderately Severe Atopic Dermatitis from AllergyCases.org.
Topical Treatment of Atopic Dermatitis
References:
Atopic Dermatitis: A Short Review. Allergy Cases.
Blog articles from AllergyNotes
Image source: Wikipedia, public domain.
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