A 21 yo F presents with several episodes of Migraine

CBC,ESR,CRP

throbbing left temporal pain that last for 2-3hrs. Tension headache

CT of head

Before onset, she sees flashes of light in her right Cluster headache

Electrolytes

visual field and feels weakness and numbness on Stroke

LP

the right side of her body for a few minutes. Her Partial Seizure

MRI of brain

headaches are often associated with nausea and Pseudotumor cerebri

vomiting. She has a family history of migraine.

CNS vasculitis

A 26 yo M presents with severe right temporal Cluster headache

CBC, ESR, CRP

headaches associated with ipsilateral rhinorrhea, Migraine

Electrolytes

eye tearing, and redness. Episodes have occurred at Temporal arteritis

CT, LP

the same time every night for the past week and Tension headache

biopsy

last for 45 minutes.

MR

Intracranial tumor

65 yo F presents with severe, intermittent right Temporal arteritis

CBC, ESR, CRP

temporal headache, fever, blurred vision in her Cluster headache

Electrolytes

right eye, and pain in her jaw when chewing.

Migraine

LP

Pseudotumor cerebri

CT,biopsy, MR

TMJ dysfunction

US of carotid A

Carotid artery dissection

30 yo F presents with frontal headache, fever, and Cluster headache

CBC, ESR, CRP

nasal discharge. Theres pain on palpation of the Sinusitis

Electrolytes

frontal and maxillary sinuses. She has a history of Migraine

X-ray of sinus

allergy.

CT of sinus

50 yo F presents with recurrent episodes of Tension headache

CBC, ESR, CRP

bilateral squeezing headaches that occur 3-4times Caffeine withdraw syndrome

Electrolytes

a week. She is experiencing significant stress in her Cluster headache

CT-head

life and recently decreased her intake of caffeine.

LP

Pseudotumor cerebri
depression

35 yo M presents with sudden severe headache, Meningitis

CBC, ESR

vomiting, confusion, left hemiplegia, and nuchal Subarachnoid hemorrhage

Electrolytes

rigidity.

Intracranial hemorrhage

LP-analysis, culx

Hypertensive crisis

Gram stain

Vertebral artery dissection

US of skull

Intracranial venous thromboi

CT
Urine toxicology

25 yo M presents with high fever, severe headache, Meningitis/encephalitis

LP-analysis, Gram

confusion, photophobia and nuchal rigidity.

SAH,migraine,

stain, Culx

Intracranial hemorrhage

CT,CBC, ESR.

Intracranial abscess
18 yo obese F presents with a pulsatile headache, Pseudotumor cerebri

Urine HCG

vomiting, and blurred vision for the past 2-3 weeks. Tension headache

CBC

Shes taking OCP.

Migraine

CT

Cluster headache

LP

Meningitis

electrolyte

Intracranial venous thro

57 yo M c/o daily pain in the right cheek for the past Trigeminal neuralgia

CBC

month. The pain is electric and stabbing in character Tension headache

ESR

and occurs while he is shaving. Each episode lasts Cluster headache

MRI-brain

2-4 minutes.

TMJ disorder

81 yo M presents with progressive confusion for the Vascular dementia

CT noncontrast

past several years accompanied by forgetfulness and Alzheimer disease

MR of brain

clumsiness. He has a history of hypertension, Chronic

subdural LP

diabetes Mellitus, and 2 strokes with residual left hematoma

CBC

hemiparesis. His mental status has worsened after NPH

VDRL/RPR

each stroke.

Hypothyroidism

TSH

Depression

Vitamin B12 level

B12 deficiency
neurosyphilis
84 yo F brought by her son c/o forgetfulness, and Alzheimer Disease

CT contrast.

difficulty performing some of her daily activities. The Neurosyphilis

MR of brain

problems has progressed gradually over the past few Hypothyroidism

LP

years

Depression

CBC

NPH

VDRL/PRP

B12 deficiency

TSH

Depression

Vitamin B12

Chronic subdural hema

72 yo M presents with memory loss, gait NPH

CT

disturbance, and urinary incontinence for the past 6 Stroke

LP

months

Chronic subdural hemat

TSH

Hypothyroidism

Electrolytes,CBC

Alzheimer disease

VDRL/RPR

55 yo M presents with a rapidly progressive change Creutzfeldt-jakob disea.

CBC, electrolytes

in mental status, inability to concentrate, and Vascular dementia

B12

memory impairment for the past 2 months. His Lewy body dementia

VDRL/RPR

symptoms are associated with myoclonus, ataxia and Wernickes

MRI

a startle response.

encephalopathy

Brain biopsy

NPH

LP(14-3-3)

Chronic subdural hemat.

Brain biopsy

VB12, neurosyphilis
70 yo insulin-dependent diabetic M presents with Hypoglycemia

Glucose

episodes

CBC, electro,

of

confusion,

dizziness,palpitation, TIA

diaphoresis, and weakness.

Arrhythmia

ECG

Delirium

US of carotid

angina

CK-MB,troponin

55 yo F presents with gradual altered mental status Subdural hematoma

Noncontrast CT

and headache. Two weeks ago she slipped, hit her SIADH

CBC, electrolytes

head on the ground, and lost consciousness for 2 Intracranial neoplasma

MRI-brain

minutes.

LP

73 yo M presents with acute loss of vision in his left Retinal artery occlusion

Fluorescein

eye, palpatations, and shortness of breath. He has a Retinal vein occlusion

angiogram

history of atrial fibrillation and cataracts in his right Acute glaucoma

Doppler US

eye. He also has no eye pain, discharge, redness, or Retinal detachment.

Intraocular

photophobia. He has not experienced headache, Temporal arteritis.

tonometry ESR

weakness or numbness.

Temporal artery Bx

68 yo M presents with a 2-month history of crying Bereavement

TSH

spells,excessive sleep, poor hygiene, and 15-lb Adjustment disorder

CBC

weight loss, all of following his wifes death. He MDD

Urine toxicology

cannot enjoy time with his grandchildren and admits Schizoaffective disorder

Beck

depression

to thinking he has seen his dead wife in line at the Depressive disorder not inventory
supermarket or standing in the kitchen making otherwise specified.
dinner.

42 yo F presents with a 4-week history of MDD

TSH

excessive fatigue, insomnia, and anhedonia. Schizoaffective disorder

CBC

She states that she thinks constantly about Substance-induced

Urine toxicology

death. She has suffered 5 similar episodes in Dysthymic disorder

Blood alcohol level

the past, the first in her 20s and has made 2

previous suicide attempts. She further admits
to increased alcohol use in the past month.
26 yo F presents with a 6.5-lb weight loss in Bipolar disorder

Urine toxicology

the past 2 months, accompanied by early Cyclothymic disorder

morning awakening, excessive guilt, and Major depressive disorder
psychomotor retardation, She does not identify Schizoaffective disorder
a trigger for the depressive episode but reports
several weeks of increased energy, sexual
promiscuity, irresponsible spending and racing
thoughts approximately 6 month before her
presentation.
19 yo M c/o receiving messages from his Schizophrenia
television set. He reports that he did not have Schizotypal

Urine toxicolog
personality TSH

many friends in high school. In college, he disorder

CBC

started to suspect his roommate of bugging the Psychotic disorder due to electrolytes
phone. He stopped going to classes because he a general medical conditi
felt that his professors were saying horrible Substance-induced
things about him that no one else noticed. He psychosis
rarely showered or left his room and has
recently been hearing a voice from his
television set telling him to guard against the
evil empire
28 yo F c/o seeing bugs crawling on her bed Substance-induced

Urine toxicolog

for the past 2 days and hearing loud voices psychosis

TSH

when she is alone in her room. She has never Schizophrenia

CBC

experienced anything similar in the past. She Brief psychotic disorder

Electrolytes

recently ingested and unknow substance.

Psychotic disorder due to BUN/Cr AST/ALT

a

general

medical

condition
48 yo F pesents with a 1-weel history of Schizoaffective disorder
auditory hallucinations that state, I am Mood

disorder

worthless, and I should kill myself She also psychotic features

TSH

with CBC
electrolytes

reports a 2-week history of weight loss, Schizophrenia

early-morning

awakening,

decreased

motivation and overwhelming feelings of gulit.

35 yo F presents with intermittent episodes of Meniere disease

CBC, electrolytes

vertigo, tinnitus, nausea, and hearing loss Vestibular neuritis

ESR,

within the past week.

Benign paroxysmal posit V

CT of head

Labyrinthitis

VDRL/RPR

Acoustic neuroma

Dix-hallpike maneuver

55 yo F c/o dizziness for the past day. She feels Orthostatic

hypotension Orthostatic VS

faint and has severe diarrhea that started 2 due to dehydration

CBC

days

for Vestibular neuritis

Electrolytes

Labyrinthitis

Rectal exam,

Vertebrobasilar

Stool exam

ago.

She

takes

hypertension.

furosemide

insufficiency
65 yo M presents with postural dizziness and Drug induced ortho hypo

Orthostatic VS

unsteadiness. He has hypertension and was Vestibular neuritis

CBC

started on HCTZ 2 days ago.

Labyrinthitis

Electrolytes

BPPV

Echocardiogram

Brain stem or cerebellar MRI-brain

neoplasma
44 yo F c/o dizziness on moving her head to BPPV

Dix-hallpike maneuver

the left. She feels that the room is spinning Vestibular neuritis

MRI

around her head. A tilt test results in Labyrinthitis

audiogram

nystagmus and nausea.

Meniere disease

55 yo F c/o dizziness that started this morning. Vestibular neuritis

CBC,electro

She is nauseated and has vomited once in the Labyrinthitis

Electronystagmography

past day. She had a URI 2 days ago and has Meniere disease

MRI-brain

experienced no hearing loss.

Vertigo associated with

cervical spine disease

55 yo F c/o dizziness that started this morning. Labyrinthitis

As bove.

And of not hearing well. She feels nauseated Vestibular neuronitis

and has vomited once in the past day. She had Meniere disease
a URI 2 days ago.

Acoustic neuroma

26 yo M presents after falling and losing Tonic-clonic seizure

CBC,electro,glucose

consciousness at work. He had rhythmic Convulsive syncope

Urine toxicology

movements of limbs, bit his tongue, and lost Malingering

EEG

control of his bladder. He was subsequently Substance abuse

MRI. CT, LP

confused after regaining consciousness.

ECG

55 yo M c/o falling after feeling dizzy and Hypoglycemia

Electrolytes, glucose,

unsteady. He experienced transient loss of TIA

ECG, CT head, CTA, v/Q

consciousness, His past medical history is Drug-induced hypo-

scan. D-dimer.

significant for hypertension and diabetes Cardiac arrhythmia

mellitus.

Stroke
Vasovagal syncope
Pulmonary embolism.

65 yo M present after falling and losing Cardiac arrhythmia

ECG, Holter monitoring

consciousness for a few seconds, he had no Aortic stenosis

CBC,electrolytes,

warning before passing out but recently had Seizure,syncope

glucose

palpitation, His history includes a coronary Pulmonary embolism

Echocardiography

artery bypass graft.

CT-head

68 yo M presents with a 20 min episodes of TIA

CT-head, US

slurred speech, right facial drooping and Hypoglycemia

CBC, electrolyte

numbness, and right hand weakness. His Stroke

Glucose, fast lipid panel

symptoms had totally resolved by the time he Seizure

ECG

got to the emergency department. He has a Facial nerve palsy

MR. EEG

history of hypertension , diabetes mellitus,

and heavy smoking.
68 yo M presents with slurred speech, right Stroke

CT-head

facial drooping and numbness and right hand TIA

CBC, electrolytes

weakness, Babinskis sign is present on the Seizure

PT/PTT/INR

right . he has a history of hypertension , Subdural or epidural hemat

Fast lipid panel

diabetes mellitus, and heavy smoking.

US,EEG,
echocardiography.

A 33 yo F presents with ascending loss of Guillain-Barre syndrome

CBC, electrolytes

strength in her lower legs over the past 2 Multiple sclerosis

CPK, MRI, EMG,

weeks, she had a recent URI.

Polymyositis

Nerve conduction

Myasthenia gravis

Tensilon test

Peripheral neuropathy

VB12 test.

Tumor in vertebral canal

Muscle biopsy

30 yo F presents with weakness, loss of Multiple sclerosis

CBC

sensation and tingling in her left leg that Stroke

ESR

started this morning. She is also experiencing Conversion disorder

VDRL/RPR

right eye pain, decreased vision, double Malingering

MRI-brain, spine

vision. She reports feelingelectric shocks CNS tumor

LP

down her spine upon flexing her head.

Retinal evoke potential

Neurosyphilis
Syringomyelia
CNS vasculitis

55 yo M presents with tingling and numbness Diabetic

peripheral Glucose, HbA1C

in his hands and feet(glove and stocking) for neuropathy.

ESR, calcium, B12

the past 2 months. He has a history of Alcoholic peripheral neuro.

UA, serum and urine

diabetes

protein electrophoresis

mellitus,

hypertension,

and B12 difficiency

alcoholism, theres decreased soft touch, Hypocalcemia

vibratory and positional sense in the feet.
40 yo F presents with occasional double Myasthenia Gravis

Tensilon test

vision and droopy eyelids at night with Horners syndrome

Ach receptor antibody

normalization by morning.

Multiple sclerosis

CXR

Intracranial neoplasma

CT-chset

Amyotrophic

lateral MRI

sclerosis

EMG

25 yo M presents with hemiparesis after a Todds paralysis

CBC, electro

tonic clonic seizure that resolved within a few TIA

EEG

hours.

Stroke

MRI

Complicated migraine

US of carotid

malingering
56 yo obese F c/o tingling and numbness of Carpal tunnel syndrome

Phalens maneuver and

her thumb, index finger, and middle finger for Overuse injury of median

tinels sign

the past 5 months. Her symptoms are Medial epicondylitis

Nerve conduction study

constant, have progressive worsened and are

TSH

relieved

CBC

with

rest.

She

works

as

secretary.she has a history of fatigue and a

20-lb weight gain over the same period.
40 yo F c/o feeling tired, hopeless, and Depression

CBC

worthless and of having suicidal thoughts. Adjustment disorder

TSH

She lost her job and has been having fights Hypothyroidism

HIV/STD

with her husband about money

anemia

44 yo M presents with fatigue, insomnia, and PTSD

CBC

nightmares about a murder that he witnessed in a Depression

TSH

mall 1 year ago. Since then, he has avoided the mall Generalized anxiety

Urine toxicology

and has not gone out at night.

Psychotic

or

delusional
55 yo M presents with fatigue , weight loss and Colon cancer

Rectal exam, FOBT

constipation .he has a family history colon cancer.

Hypothyroidism

CBC

Renal failure

Electro, BUN/Cr,Ca

Hypercalcemia

AST/Alt

depression

TSH
Colonoscopy
CT- abdomen

40 yo F presents with fatigue, weight gain, Hypothyroidism

TSH, FT4,FT3

sleepiness, cold intolerance, constipation and dry Atypical depression

CBC, fasting blood gluc

skin.

HbA1c

Diabetes.

50 yo obese F presents with fatigue and daytime Obstructive sleep apn

CBC

sleepiness. She snores heavily and naps 3-4times Hypothyroidism

TSH

per day but never feels refreshed. She also has Chronic fatigue syn

Polysomography

hypertension.

ECG

nacrolepsy

20 yo M presents with fatigue , thirst, increased Diabetes mellitus

Glucose

appetite and polyuria.

Atypical depression

HbA1C

Primary polydipsia

UA

Diabetes insipidus

CBC
Electrolytes,BUN/Cr

30 yo M presents with night sweats, cough, and TB

CXR, PPD, CBC, sputum

swollen glands of 1 month;s duration, He recently Lymphoma,leukemia

stain,

emigrated from the African subcontinent.

antibody, TSH.

Acute HIV infection

culture.

HIV

hyperthyrodism
35 yo M policeman c/o feeling tired and sleepy Shift

work

sleep CBC

during the day. He changed to the night shift last disorder

Nocturnal

week.

Sleep apnea

oximetry

Depression

polysomnography

anemia

45 yo F presents with excessive sweating, Hyperthyroidism

TSH, FT3, FT4.

pulse

unintentional weight loss, palpitation, diarrhea, Pheochromocytoma

24h urine catecholami

and shortness of breath.

Carcinoid syndrome

serotonin

TB

CBC,PPD

26 yo F presents with sore throat, fever, severe Infectious mononucle

CBC, electrolytes,

fatigue, and loss of appetite for the past week. She GERD,

Monospot test

also reports epigastric and LUQ discomfort. She has Hepatitis,

Throat culture

cervical

AST/ALT/ALP/Biliru

lymphadenopathy

and

rash.

Her Pharyngitis

boyfriend recently experienced similar symptoms

Acute HIV

HIV antibody+load
antiEBV, VDRL/RPR

26 yo M presents with sore throat, fever, rash and Acute HIV syndrome

HIV antibody+ load

weight loss. He has a history of IV drug abuse and Infectious mono

Monospot test

sharing needles.

Hepatitis

AST/Alt.

Pharyngitis

Throat culture

Tonsillitis, scarlet feve

CBC with peripheral

smear

46 yo F presents with fever and sore throat.

Pharyngitis

Throat swab for cultu

Mycoplasma

and rapid antigen test

pneumonia

Monospot

Infectious mononucle

CBC
Serology
HIV

30 yo M presents with shortness of breath, cough, Asthma

CBC, CXR,

and wheezing that worsen in the cold air. He has GERD

Peak follow measurem

had several such episodes in the past 4 months.

Bronchitis

PFTs

Pneumonia

Methacholine challen

Foreign body
58 yo M presents with 1 week of pleuritic chest Pneumonia,

Sputum culture, CBC

pain, fever, chills, and cough with purulent yellow COPD exacerbation

CXR

sputum. He is a heavy smoker with COPD.

Lung abscess

Chest CT

Lung cancer

ECG

Tuberculosis

PFTs,PPD

56 yo F presents with shortness of breath and a COPD

CBC, sputum culture

productive cough that has lasted for at least Pneumonia

CXR, PFTs

3months each year over the past 2 years, She is a Lung cancer

CT

very heavy smoke.

PPD

tuberculosis

25 yo F presents with 2 weeks of nonproductive Atypical pneumonia

IgM detection

cough. 3 weeks go she had a sore throat and a Reactive airway disea

Urine legionella antige

runny nose.

Post-nasal drip

CXR,CBC

GERD

Induced sputum G+
agglutinin

65 yo M presents with worsening cough for the Lung cancer

CBC, PPD

past 6 months accompanied by hemoptysis, TB,COPD

CXR, chest CT

dyspnea, weakness, and weight loss. He is a heavy Lung abscess

c-ANCA

smoke.

Vasculitis

bronchoscopy

CHF

echocardiogram
sputum culture

55 yo M presents with increased dyspnea and CODP exacerbation

CBC, PPD, PFTs, CXR.

sputum production for the past 3 days. He has copd Pneumonia

Sputum stain and culx

and stopped using his inhalers last week. He Asthma

ABG,

stopped smoking 2 days ago.

TB, URI

34 yo F nurse presents with worsening cough of 6 TB.

PNA

PPD, sputum

weeks duration accompanied by weight loss, Lung abscess

CXR, CT

fatigue, night sweats and fever. She has a history of Vasculitis, lymphoma

ANCA

contact with tuberculosis patients work

Metastatic cancer

Bronchoscopy

sarcoidosis

HIV,

35 yo M presents with shortness of breath and TB, pneumonia

CBC, PPD

cough. He has had unprotected sex with multiple Bronchitis

CXR, PFts

sexual partners and was recently exposed to a Asthma, acute HIV

HIV

patient with active tuberculosis.

60 yo M presents with worsening dyspnea of 6 Pulmonary edema

ECG,CXR,CBC,

hours duration and a cough that is accompanied by CHF

PFTs, BNP.

pink frothy sputum.

ABG,

Mitrial valve
Arrhythmia
asthma

50 yo M presents with a cough that is exacerbated CHF

Echo cardiogram,BNP

by lying down at night and improved by propping Cardiac valvular disea

ECG, electrolytes, PFTs

up on 3 pillows. He also reports exertional dyspnea. GERD,

COPD, CXR

postnasal dripping

60 yo M presents with sudden onset of substernal Myocardial infarction

CXR,

ECG,

CBC,

heavy chest pain that has lasted for 30 minutes and Angina

electrolytes.

radiates to the left arm. The pain is accompanied by GERD

Troponin, CK-MB, AST

dyspnea, diaphoresis, and nausea, He has a history Pericarditis

D-dimer

of hypertension , hyperlipidemia and smoking.

Costochondritis

Cardiac

Aortic dissection

catherterization

20 yo African American F presents with acute onset Sickle cell anemia

CXR

of severe chest pain for a few hours. She has a -acute chest syndrome

CBC,peripheral smear

history of sickle cell anemia and multiple pulmonary embolism

LDH, D-dimer.

hospitalization for pain and anemia management.

Pneumonia

CK-Mb,troponin

MI

ECG

Pneumothorax

ABG

Aortic dissection
45 yo F presents with a retrosternal burning GERD,

24 hr PH monitoring

sensation that occurs after heavy meals and when Esophagitis

endoscopy

lying down. Her symptoms are relieved by antacids

Peptic ulcer disease

barium swallow

Esophageal spasm

ECG

55 yo M presents with retrosternal squeezing pain MI

ECG, Ck-MB

that lasts for 2 minutes and occurs with exercise, It Stable Angina

Troponin

is relieved by rest and is not related to food intake.

Esophageal spasm

CXR, CBC

esophagitis

Electrolytes
Exercise stress test

34 yo F presents with retrosternal stabbing chest Pericarditis

CXR, echocardiography

pain that improves when she leans forward and Aortic dissection

CBC, upper endoscopy

worsens with deep inspiration. She had a URI 1 MI, costochondritis

ESR.

week ago.

GERD,

esophageal

rupture.
33 yo F presents with stabbing chest pain that Costochondritis

ECG

worsens with deep inspiration and is relieved by Pneumonia

CPK-MB, troponin

aspirin, She had a URI 1 week ago. Chest wall MI

CXR

tenderness is noted

CBC

Pulmonary embolism
pericarditis

70 yo F presents with acute onset of shortness of Pulmonary embolism

D-dimmer

breath at rest and pleuritic chest pain. She also Pneumonia

CXR, CTA

presents with tachycardia, hypotension , tachypnea Costochondritis

ABG, CK-MB, troponin

and mild fever. She is recovering from hip MI,CHF

DOPPLER- leg

replacement surgery.

Aortic dissection

55 yo M presents with sudden onset of severe chest Aortic dissection

ECG, CK-MB

pain that radiates to his back. He has a history of MI,pericarditis

Troponin

uncontrolled hypertension.

Esophageal rupture

CXR,CBC

Esophageal spasm

Transesophegeal EE

pancreatitis

MRA,amylase, lipase
CTA

70 yo Diabetic M presents with episodes of Hypoglycemia

Glucose,

CBC,

palpitations and diaphoresis, He is on insulin.

Cardiac arrhythmia

electrolyte

Angina

TSH,

Hyperthyroidism

moniter

Hyperventilation

24hr catecholamine

Panic attack

5-HIAA

ECG,

Holter

Pheochromocytoma
Carcinoid syndrome
35 yo M presents with several episodes of Panic attack

Electrolytes

palpitations,

TSH, FT3,FT4

sweating,

and

rapid

breathing. Anxiety disorder

Episodes occur unexpectedly, and he does not recall Acute stress disorder

ECG

any triggers. He has had 4-5 episodes per month Specific phobia

Echo

for several months. Each episodes lasts2-3 minutes. Hyperthyroidism

Urine toxicology

He does not have an history of psychiatric illness Agoraphobia

25hr catecholamine

except for separation anxiety as a child.

Substance abuse

19 yo F presents with episodic palpitations, Social phobia

TSH, FT4,FT3

especially during presentations in front of her class. Avoidant personality

ECG

Episodes include heart pounding, facial blushing, General anxiety

Echo

and hand tremor, she also experiences excessive Hyperthyroidism

CBC, electrolytes

sweating and rapid breathing, She complains of Panic attack

intense worry and trouble sleeping for days or agoraphobia
weeks before an upcoming social situation, Now
she avoids all social events. Because she is afraid of
humiliating herself.
34 yo F presents with episodic palpitations Mitral valve prolapse

ECG.echo,

accompanied

by

lightheadedness

and

sharp, Cardiac arrhythmia

atypical chest pain.

Holter monitor

Panic attack

24hr

urinary

pheochromocytoma

catecholamines

42 yo F presents with a 7 kg weight loss within the Hyperthyroidism

TSH, FT4

past 2 months. She has a fine tremor, and her pulse Cancer

CBC

is 112.

HIV

Electrolytes

Dieting

HIV antibody

Anorexia nervosa

Urine toxicology

malabsorption
44 yo F presents with a weight gain of >11.3Kg Smoking cessation

CBC,electrolytes, gluco

within the past 2 months. She quit smoking 3 Drug side effect

TSH, 24hr urine cortiso

months ago and is on amitriptyline for depression. Hypothyroidism

Dexamethasone test

She also reports cold intolerance and constipation.

Cushing syndrome
Polycystic ovary synd
Diabetes mellitus
Atypical depression

30 yo F presents weight gain over the past 3 Insulinoma

months.

She

also

reports

Blood

glucose

and

tremor,palpitation, Reactive postprandial plasma insulin

anxiety, and hunger that is relieved by eating. She hypoglycemia

exhibits proximal muscle weakness and easy Cushings syndrome

Glucose tolerance test

bruising.

24hr free cortisol

75 yo M presents with dysphagia that started with Esophageal cancer

Endoscopy

solids and progressed to liquids. He is an alcoholic Achalasia

Barium swallow

and a heavy smoker. He has had an unintentional Esophagitis

CT-chest

weight loss of 15 lbs within the past 4 months.

Systemic sclerosis

CXR

Esophageal stricture

CBC

45 yo F presents with dysphagia for 2 weeks Plummer vinson syndr CBC, serum iron
accompanied by mouth and throat pain, fatigue, Esophageal caner

Ferritin, TIBC

and a craving for ice and clay.

Esophagitis

Barium swallow

Achalasia

endoscopy

Systemic sclerosis

48 yo F presents with dysphagia for both solids Achalasia

Endoscopy

and liquids that has slowly progressed in severity Plummer-vinsion

CXR

within the past year, Its associated with difficulty Esophageal caner

Barium swallow

belching and regurgitation of undigested food, Esophagitis

Esophageal manome

especially at night. She has lost 2.5kg in the past 2 Systemic sclerosis

XR-neck

months.

Mitral valve stenosis

Zenkers diverticulum

38 yo M presents with dysphagia and pain on Esophagitis

CBC, endoscopy

swallowing solids more than liquids. Exam Systemic sclerosis

Barium swallow

reveals oral thrush.

HIV test

GERD
Esophageal stricture
Zenkers diverticulum

39 yo F presents with a single 2-cm mass on the Lymphoma

CBC

right side of her neck along with night sweats, Tuberculosis

Electrolytes, ESR, CRP

fever, weight loss, loss of appetite, and early Thyroid nodule

Lymph node biopsy

satiety. The mass is painless and movable and has Gastric carcinoma

PPD, CXR

not changed in size. She does not report heat

TSH

intolerance,

US/thyroid

tremor,

palpitation,

hoarsness,

cough, ,difficulty breathing, difficulty swallowing,

Upper endoscopy.

or abdominal pain. Her husband was recently

discharged from prison. And her mother has a
history of gastric cancer.
20 yo F presents with nausea vomiting(especially Pregnancy

Urine HCG

in the morning), fatigue, and polyuria. Her last Gastritis

Pelvic

menstrual period was 6 weeks ago, and her Hypercalcemia

US

breasts are full and tender. She is sexually active Diabetes mellitus

CBC,eletrolytes, Ca2+

with her boyfriend and they occasionally use UTI

Glucose, urine culture

condom for contraception

HIV antibody

Depression

45 yo M presents with sudden onset of colicky Nephrolithiasis

US, urine analysis

right sided flank pain that radiates to the Renal cell carcinoma

BUN/Cr,

testicles, accompanied by nausea, vomiting, Pyelonephritis

CT, KUB, IVP, blood clx

hematuria, and CVA tenderness

Appendicitis

60 yo M presents with dull epigastric pain that Pancreatic cancer

CBC, electrolytes

radiate to the back, accompanied by weight loss, HCC,acute viral hepati

Amylase, lipase

dark urine, and clay-colored stool, He is a heavy Cholangiocarcinoma

AST, ALT, bilirubin

drinker and smoker. He appears jaundiced on Chronic panreatitis

Alkaline phosphatase

exam

56 yo M presents with severe midepigastric Acute pancreatitis

CBC,

electrolytes,

abdominal pain that radiates to the back and Peptic ulcer disease

amylase,

improves when he leans forward. He also reports Cholecystitis

AST/ALT bilirubin

anorexia, nausea and vomiting, he is an alcoholics Gastritis

ALP

and has spent the past 3 days binge drinking.

Abdominal aneurysm

US

Mesenteric ischemia

CT,upper endoscopy

Alcoholic hepatitis

ECG

lipase,

41 yo obese F presents with RUQ abdominal pain Cholecystitis

CBC, ESR, electrolytes

that radiates to the right scapula and is Choledocholithiasis

AST, ALT, bilirubin

associated with nausea, vomiting, and a fever of Hepatits

US

101F, The pain started after she ate fatty food. Ascending cholangitis

CT, HBV antigen test

She has had similar but less intense episodes that Peptic ulcer disease
lasted a few hours. Exam reveals a positive
Murphys sign.
43 yo obese F presents with RUQ abdominal pain, Ascending cholangitis
fever and jaundice, she was diagnosed with Acute

CBC, ESR, electrolytes

gallstone AST/ALT/ALP/bilirubin

asymptomatic gallstones 1 yr ago, she is found to cholangitis

US, CT

be hypotensive on exam.

Acute cholecystitis

HIDA,ERCP

Hepatitis

Blood culture

Sclerosing cholangitis

Viral hepatitis serology

25 yo M presents with RUQ pain , fever anorexia, Acute hepatitis

As above

nausea, and vomiting. He has dark urine and Acute cholecystitis

clay-colored stool.

Ascending cholangitis
choledocholithasis

35 yo M presents with burning epigastric pain Peptic ulcer disease

H,pylori test

that starts 2-3 hrs after meals. The pain is Gastritis, chronic panc

Endoscopy, FOBT

relieved by food and antacid.

24hr PH monitoring

GERD, mesenteric ische

upper GI series
AST, ALT,ALP
A 37 yo M presents with severe epigastric pain, Perforated peptic ulcer

CT,XR of abdomen

nausea, vomiting and mild fever. He appears Acute pancreatitis

ESR, lipase, amylase

toxic. He has a history of intermittent epigastric Hepatitis

AST/ALT/ALP/bilirubin

pain that is relieved by food and antacid. He also Cholecystitis

US of gallbladder,KUB

smokes heavily

Gallstone cholangitis

Endoscopy

Mesenteric ischemia

Blood culture

18 yo Boxer presents with severe LUQ abdominal Splenic rupture

CT, FAST(unstable)

pain that radiates to the left scapula. He had Kidney stones

infectious mononucleosis 3 weeks ago.

CBC, CXR, eletrolytes

Rib fracture
pneumonia

40 yo M presents with crampy abdominal pain , Intestinal obstruction

Xr,

vomiting, abdominal distention, and inability to Small bowel cancer

electrolytes

pass flatus or stool. He has a history of multiole Volvulus

Rectal exam

abdominal surgeries.

CT, colonoscopy

Gastroenteritis,hernia

CBC,

ESR,

Food poisoning , ileus,

70 yo F presents with acute onset of severe , Ischemic colitis

AXR,CT,colonoscopy

crampy abdominal pain. She recently vomited Colon cancer

Digitalis concentration

and had a massive dark bowel movement. She Digitalis side effect

ECG, Barium enema

has a history of CHF and atrial fibrillation, for Volvulus, diverticulitis

angiography

which she has received digitalis. Her pain is out

proportion to the exam.
21 yo F presents with acute onset of severe RLQ Ovarian torsion

Pelvic exam

pain, nausea, and vomiting. She has no fever, Appendicitis

Urine HCG

urinary symptoms, or vaginal bleeding and has Nephrolithiasis

US, rectal exam, UA

never taken OCPs. Her last menstrual period was Ectopic pregnancy

CBC, CT-abdomen

regular, and she has no history of stds . She has Ruptured ovarian cyst

Laparoscopy

been told that she had a cyst on her right ovary.

Chlamydia

PID, bowel infarction

and

gonorrhea testing
68 yo M presents with LLQ abdominal pain, fever, Diverticulitis

Rectal exam

and chills for the past 3 days. He also reports Crohns disease

CBC

recent

Electro, CXR, AXR

onset

of

alternating

diarrhea

and UC

constipation. He consumes a low-fiber, high fat Colon cancer

diet.

CT, blood culture

IBS

20 yo M presents with severe RLQ abdominal Appendicitis

CBC, electrolytes, CT

pain, nausea, and vomiting. His discomfort Gastroenteritis

AXR, US-

started yesterday as a vague pain around the Diverticulitis

Blood culture

umbilicus . As the pain worsened, it became Crohns disease

sharp and migrate to the RLQ. Mcburneys and Nephrolithiasis
psoas sign are positive.

volvulus

30 yo F presents with periumbilical pain for 6 Irritable bowel syndro

Rectal exam, FOBT

months, the pain never awakens her from sleep. It Crohns disease

Pelvic exam

is relieved by defecation and worsen when she is Celiac disease

Urine HCG

upset. She has alternating constipation and Chronic pancreatitis

CBC, electro

diarrhea but no nausea, vomiting, weight loss, or GI parasitic infection

Colonoscopy

anorexia.

CT, stool for ova

endometriosis

24 yo F presents with bilateral lower abdominal PID

Pelvic exam

pain that started with the first day of her menstrual Endometriosis

UA, cervical culture

period. The pain is associated with fever and a Dysmenorrhea

Laproscopy

thick greenish-yellow vaginal discharge. She has Vaginitis,cystitis

Urine HCG,

had unprotected sex with multiple sexual partners

CBC, US

pyelonephritis

67 yo M presents with alternating diarrhea and Colorectal cancer

CT, rectal exam, FOBT

constipation, decreased stool caliber, and blood in Irritable bowel syndro

CBC, electro

the stool for the past 8 months, he also reports Diverticulosis

Colonoscopy

unintentional weight loss. He is on a low fiber diet GI parasitic

AST, ALT, ALP, bilirubin

and has a family history of colon cancer, His last IBD

Barium enema

colonoscopy was 12 years ago.

28 yo M presents with constipation(hard stool) for Lowe-fiber diet

Rectal exam, TSH, elect

the past 3 weeks, since his mother died 2 months Depression

Urine toxicology

ago, he and hisfather have eaten only junk food.

Substance abuse

30 yo F presents with alternating constipation and Irritable syndrome

Rectal exam. FOBT

diarrhea accompanied by abdominal pain that is IBD

cBC, electrolytes

relieved by defecation. She has no nausea, vomiting, Celiac disease

colonoscopy

weight loss, or blood in her stool.

stool for O&P, ct

Chronic pancreatitis

40 yo F presents with watery diarrhea and Pseudomembranous

Stool for difficile toxin

abdominal cramps. Last week she was on antibiotic Gastroenteritis

Rectal exam, FOBT

s for a UTI.

Cryptosporidiosis

Stool leukocytes

Food poisoning

CBC, electrolytes

33 yo M presents with watery diarrhea, vomiting, Infectious diarrhea

Rectal exam, FOBT

and diffuse abdominal pain that began yesterday. Food poisoning

Stool leukocyte and clx

He also reports feeling hot. Several of his

CBC, electrolyte

coworkers are also ill.

CT

25 yo M presents with watery diarrhea and Travelers diarrhea

Rectal exam, FOBT

abdominal cramps. He was recently in Mexico.

Giardiasis

Stool for WBC and cl

Amebiasis

O&P

Food poisoning

Serology Heptitis A

Hepatitis A

AST

30 yo F presents with watery diarrhea, abdominal Lactose intolerance

Rectal.

cramping,

Stool WBC& clx

and

bloating.

Her

symptoms

are Gastroenteritis

aggravated by milk ingestion and are relieved by fast

IBD,IBS,

Hydrogen breath tes

33 yo M presents with watery diarrhea, diffuse IBD

Rectal exam

abdominal pain, and weight loss within the past 3 Celiac disease

Stool WBC, clx

weeks, he has a history of aphthous ulcers. He has Gastroenteritis

O&P, CT, 5-HIAA,

not responded to antibiotics

Colonoscopy

Carcinoid syndrome

Small bowel series

45 yo F presents with coffee-ground emesis for the Bleeding peptic ulcer

Rectal exam

past 3 days. Her stool is dark and tarry. She has a Gastritis

CBC, type and cross

history of intermittent epigastric pain that is relieved Gastric cancer

Electrolytes

by food and antacid.

AST/ALT/bilirubin

Esophageal varices

INR
40 yo F presents with epigastric pain and coffee Gastritis

Rectal exam

ground emesis, she has a history of rheumatoid Bleeding peptic ulcer

CBC,type and cross

arthritis that has been treated with NSAIDs. She is an Gastric caner

Electro

alcoholic.

Esophageal varices

AST/ALT..

Mallory-Weiss tear

INR

67 yo M presents with blood in his stool, weight loss, Colorectal cancer

Rectal exam

and constipation. He has a family history of colon Anal fissure

CT, CBC, AST..

cancer.

Diverticulosis

INR, colonoscopy

Hemorrhoids

CEA

Ischemic bowel disease

Angiodysplasia
33 yo F presents with rectal bleeding and diarrhea Ulcerative colitis

Colonoscopy, CBC,

for the past week. She has had lower abdominal pain Crohns disease

ESR, stool culture

and tenesmus for several months

Procitis,dysentary

Rectal exam

Anal fissure

INR, PT/PTT

hemorrhoid

58 yo M presents with painless bright red blood per Diverticulosis

Rectal exam

rectum and chronic constipation. He consumes a low Colorectal cancer

CBC, type and cross

fiber diet.

Angiodysplasia

PT/PTT

Hemorrhoids

Elelctrolytes

Anal fissure

Colonoscopy
Tagged RBC scan

65 yo M presents with painless hematuria, he is a Bladder cancer

Genitourinary exam

heavy smoker and works as a painter.

UA, urine cytology

Nephrolithiasis

UTI, glomerulonephritis PSA, CBC, CT, US

Renal cell carcinoma

cystoscopy

35 yo M presents with painless hematuria. He has a Polycystic kidney dis

US, CT, PT/PTT

family history of kidney disease.

Nephrolithiasis

UA, urine cytology

IgA nephropathy

BUN/Cr

Bladder caner

cystoscopy

55 yo M presents with flank pain and blood his urine Renal cell carcinoma

Genitourinary exam

without dysuria. He has experienced weight loss and Bladder caner

UA, urine cytology

forever over the past 2 months. Exam reveals a flank Nephritis

BUN/Cr, PT/PTT

mass

Cystoscopy, US, CT

Prostate cancer

CBC
60 yoM presents with nocturia, urgency , weak BPH,prostate cancer

Rectal exam

stream, and terminal dribbling. He denies any weight UTI, bladder stones

UA, PSA, cystoscopy

loss, fatigue, or bone pain. He has had 2 episodes of

BUN/Cr

urinary retention that required catheterization.

ALP
US

18 yo M presents with aburning sensation during Urethritis

Genital and rectal

urination and urethral discharge. He recently had Cystitis

exam,UA, Urine clx

unprotected sex with a new partner.

Gram

prostitis

stain

and

culture of urethral
discharge
Chlamydia
gonorrhea
71 yo M presents with nocturia, urgency, a weak Prostate cancer

Rectal exam

stream, terminal dibbling, hematuria, and lower BPH

UA, CBC

back pain for the past 4 months. He has also Renal cell carcinoma

BUN/cr

experienced weight loss and fatigue

PSA, US

UTI
Bladder stones

and

45 diabetic F presents with dysuria, urinary Pyelonephritis

UA, urine culture

frequency, fever, chills, and nausea for the past 3 days.

Nephrolithiasis

Blood culture

There is left CVA tenderness on exam

Lower UTI

CBC, BUN/Cr

Renal cell carcinoma

US,CT

55 yo F presents with a small amount of urine when Stress incontinence

UA, urine culture

she coughs, laughs, or sneezes, she also complains of Mixed incontinence

BUN/Cr,

vague llow back pain, she has a history of multiple Urge, overflow

Urodynamic test

vaginal deliveries, and her mother had the same

IVP

problems after the onset of menopause.

cystoyrethroscopy

33 yo F presents with urinary leakage. She is unable to Urge incontinence

CBC,electro,BUN/Cr

suppress the urge to urinate and loses large amounts Mixed

UA, culture

of urine without warning. She has a history of uTIs

Urodynamic test

and afamily history of diabetes mellitus. She drinks 8

IVP,

cups of coffee per day. She has been under stress since

cystourethroscopy

her sister passed away a few months ago

47 yo M presents with impotence that started 3 Drug-related ED

Genital, rectal

months ago, he has hypertension and was started on HTN-

Glucose

atenolol 4 months ago. He also has diabetes and is on DM-

CBC,

insulin.

Psychogenic

Testostone,

Peyronies disease

HbA1C, US

40 yo F presents with amenorrhea, morning nausea Pregnancy

HCG,US, LH/FSH

and vomiting, fatigue,, and polyuria. Her last Anovulatory cycle

Prolactin

menstrual period was 6 weeks ago, and her breast are Hyperprolactinemia

MR,TSH, FT3,FT4

full and tender. She uses the rhythm method of UTI

Pelvic exam

contraception

UA, urine culture

Hypothyrodism

HIV,HBV,VDRL/RPR
23 yo obese F presents with amenorrhea for 6 PCOS

US, pelvic

months, facial hair, and infertility for the past 3 years

Hyperprolactinemia

TG, glucose, chole

Pregnancy

FSH/LH. HCG

Thyroid disease

TSH, lactin
DHEAS, testosterone

35 yo F presents with amenorrhea, galactorrhea, visual Amenorrhea

HUG, FSH/LH, TSH

field defects, and headaches for the past 6 months.

secondary

to Prolactin

prolactinoma

MRI

Pregnancy

Pelvic and breast

Thyroid disease
48 yo F presents with amenorrhea for the past 6 Menopause

HCG, TSH, FSH/LH

months accompanied by hot flashes, night sweats, Pregnancy

Testosterone

emotional lability, and dyspareunia.

Pituitary tumor

DHEAS

Thyroid disease

Pelvic exam
CBC

35 yo F presents with amenorrhea, cold intolerance, Sheehans syndrome

Urine HCG

coarse hair, weight loss, and fatigue. She has a history Premature ovarian F

LH/FSH

of abruptio placenta followed by hypovolemic shock Thyroid disease

Prolactin

and failure of lactation 2 years ago.

CBC, pelvic,

Ashermans syndrome

TSH,
ACTH,hysteroscopy
18 yo F presents with amenorrhea for the past 4 Anorexia nervosa

Urine HCG

months. She is 5 feet, 6 inches, and 90lbs. She has a Pregnancy

CBC

history of exercise and heat intolerance

TSH, FT4

hyperthyroidism

LH/FSH
29 yo F presents with amenorrhea for the past 6 Anxiety-induced

CBC, TSH, FT4

months, She has a history of occasional palpitations PTSD

Urine cortisol

and dizziness. She lost her fianc in a car accident in Depression

Progesterone

which she was a passenger.

challenge test

hyperthyrodism

LHFSH
61 yo obese F presents with profuse vaginal bleeding Endometrial carcin

US,

endometrial

for the past month, her last menstrual period was 10 Cervical cancer

biopsy curettage

years ago, she has a history of hypertension, and Atrophic endometriu

LH/FSH, pelvic exa

diabetes mellitus. She is nulliparous.

Endometrial hyperpl

Pap smear

Endometrial polp

US, colposcopy

Atrophic vaginitis

hysteroscopy

17 yo F presents with prolonged, excessive menstrual Dysfunction uterine b

HCG, PT/PTT

bleeding occurring irregularly within the past 6 months Coagulation disorder

Genital exam

Cervical cancer

Pap smear

Hypothyroidism

Cervical culture
LH/FSH prolactin

45 yo G5P5 presents with postcoital bleeding. She is a Cervical cancer

Pap smear

cigarette smoker and takes ocps

Endometrial cancer

Colposcopy

Cervical polyp

Endometrial

Cervicitis

curettage,pelvic

trauma

HPV testing

28 yo F who is 8 weeks pregnant presents with lower Spontaneous aborti

Urine HCG

abdominal pain and vaginal bleeding.

Ectopic pregnancy

US,pelvic US

Molar pregnancy

CBC,PT/PTT

32 yo F presents with sudden onset of left lower Ectopic pregnancy

Pelvic exam

abdominal pain that radiates to the scapula and back and Rupture ovarian cys

HCG,US

is associated with vaginal bleeding. Her last menstrual PID

Cervical cultures

period was 5 weeks ago, she has a history of pelvic

inflammatory disease and unprotected intercourse.
28 yo F presents with a thin, grayish-white, foul-smelling Bacterial vaginosis

Pelvic exam

vaginal discharge.

Vaginitis

Vaginal culture, G

cervicitis

KOH prep
Wet mount, PH

30 yo F presents with a thick, white, cottage cheese-like, Candida vaginitis

Pelvic exam

odorless vaginal discharge and vaginal itching.

Wet mount, KOH

Trichomonal

prep, whiff test

Vaginal culture, G
54 yo F c/o painful intercourse. Her last menstrual Atrophic vaginitis

Pelvic exam

period was 9 months ago, she has hot flashes.

Endometriosis

LH/FSH

cervicitis

Wet mount, KOH

prep
Cervical cultures

37 yo F presents with dyspareunia, inability to conceive Endometriosis

Pelvic exam

and dysmenorrhea.

Cervisitis

US, wet mount ,

vaginismus

KOH

35 yo F presents with a malodorous, profuse, frothy, Trichomonal

Pelvic exam

greenish vaginal discharge with intense vaginal itching Cervicitis

Wet mount, KOH

and discomfort.

prep, whiff test

vaginosis

Vaginal culture, G

54 yo F c/o painful intercourse. Her last menstrual period Atrophic vaginitis

Pelvic exam

was 9 months ago. She has hot flashes.

Endometriosis

KOH prep, wet mo

cervicitis

Cervical culture
LH/FSH

37 yo F presents with dyspareunia, inability to conceive, Endometriosis

Pelvic exam

and dysmenorrhea.

Cervicitis

Laparoscopy

Vaginismus

Endometrial biops

PID

US, cervical cx

28 yo F c/o multiple facial and bodily injuries. She claims Domestic abuse

XR-skeletal

that she fell on the stairs. She was hospitalized for physical OI

CT

injuries 7 months ago. She presents with her husband.

Urine toxicology

Substance abuse

CBC
30 yo F presents with multiple facial and physical injuries. Rape

Forensic

She states that she was attacked and raped by 2 men.

exam(SAFE

Domestic violence

collection kit)
Pelvic exam
UCG, US, HIV, HBV
Rubella,syphilis
Gonorrhea
Chlaymidia
CBC,XR-skeletal
30 yo F presents with wrist pain and a black eye after Domestic violence

xR-wrist

tripping, falling, and hitting her head on the edge of a Factitious disorder

CT-head

table. She looks anxious and gives an inconsistent story.

Urine toxicology

Substance abuse

28 yo F presents with pain in the interphalangeal joints of SLE

ANA, anti-dsDNA

her hands accompanied by hair loss and a rash on her face

Rheumatoid arthrit

ESR, C3,C4,RF,CCP

Psoriatic arthritis

CBC, XR-hands

Parvovirus B19

UA,antibody titers

30 yo F secretary presents with wrist pain and sensation Carpal tunnel synd

Phalens maneuver

of numbness and burning in her palm and the first, second Median nerve com

TInels sign

and third fingers of her right hand. The pain worsens at Radiculopathy
night and is relieved by loose shaking of the hand. Thereis the nerve roots
sensory loss in the same fingers, Exam reveals a positive De
Tinels sign

of Finkelsteins test
Nerve conduction

Quervains EMG

tenosynovitis

28 yo F presents with pain in the metacarpophalangeal RA,SLE

RF, CCP, ANA, ESR

joints of both hands. Her left knee is also painful and red . Disseminated gono

dsDNA

she has morning joint stiffness that lasts for an hour, her Arthritis associated CBC,
mother had rheumatoid arthritis.

with IBD

cervical

culture
Arthrocentesis,XR

18 yo M presents with pain in the interphalangeal joints of Psoriatic arthritis

ANA, ESR, CCP, RF

both hands. He also has scaly, salmon-pink lesions on the Rheumatoid

CBC, xR-sacroiliac

extensor surface of his elbows and knees.

Uric acid

SLE
Gout

65 yo F presents with inability to use her left leg or bear Hip fracture

XR- hips/pelvic

weight on it after tripping on a carpet, onset of menopause Hip dislocation

CT or MRI of hip

was 20 years ago, and she did not receive HRT or calcium Pelvic fracture

CBC,

supplements. Her left leg is externally rotated, shortened,

cross

and adducted. And theres tenderness in her left groin.

Serum calcium and

type

and

Vd
Bone density scan
40 yo M presents with pain in the right groin after a motor Hip dislocation

XR-hip

vehicle accident. His right leg is flexed at the hip, adducted Hip fracture

CT or MRI-hip

and internally rotated.

CBC, type and cros

PT/PTT

56 yo obese F presents with right knee stiffness and pain Osteoarthritis

XR-knee

that increases with movement. Her symptoms have Pseudogout

CBC, ESR

gradually worsened over the past 10yr. she has noticed Gout

Knee arthrocentesi

swelling and deformity of the joint and is having difficulty Meniscal

walking.

or And fluid analysis

ligament damage

Uric acid and MRI

65 yo M presents with right foot pain. He has been training Stress fracture

XR-foot

for a marathon

Plantar fasciitis

MRI-foot

Foot sprain or strai

Bone scan

45 yo M presents with fevers and right knee pain with Septic arthritis

CBC, knee arthro

welling and redness.

Gout

Blood urethral clx

Pseudogout

XR-knee

Lyme arthritis

Uric acid

Trauma

Lyme

Reiters syndrome

and IgG.

65 yo M presents with pain in the heel of the right foot Plantar fasciitis

XR-heel

titers-IgM

that is most notable with his first few steps and then Heel fracture

Bone scan-foot

improves as he continues walking. He has no known Splinter/foreign

trauma.

body

55 yo M presents with pain in the elbow when he plays Tennis elbow

XR-arm

tennis. His grip is impaired as a results of the pain. There Stress fracture

Bone scan

is tenderness over the lateral epicondyle as well as pain on

MRI-elbow

resisted wrist dorsiflexion with the elbow extension

27 yo F presents with painful wrists and elbows , a Disseminated gono

Knee arthrocente

swollen and hot knee joint that is painful on flexion, a rash RA

ANA, anti-dsDNA

on her limbs, and vaginal discharge. She is sexually active SLE

ESR, CCP

with multiple partners and occasionally uses condoms.

CBC

Reiters syndrome

Blood culture
XR-knee
60 yo F present with pain in both legs that is induced by Peripheral vascular

Ankle-brachial in

walking and is relieved by rest. She had cardiac bypass Leriche syndrome

Doppler US

surgery 6 months ago and continues to smoke heavily

Lumbar spinal sten

Angiography

osteoarthritis

MRI-L spine

45 yo F presents with right calf pain. Her calf is tender, DVT

warm, red and swollen compared to the left side. She was Bakers

US
cyst CBC

started on OCPs 2 months ago for dysfunctional uterine rupture

bleeding.

D-dimer

Myositis
cellulitis

50 yo M presents with right shoulder pain after falling Shoulder dislocate

XR-shoulder/arm

onto his outstretched hand while skiing, he noticed Fracture of the hu

MRI-shoulder

deformity of his shoulder and had his right arm.

Rotator cuff injury

55 yo M presents with crampy bilateral thigh and calf pain, Rhabdomyolysis

CBC

fatigue and dark urine. He is on simvastatin and clofibrate Polymyositis

Phosphate,

for hyperlipidemia.

potassium

Inclusion body

Bun/cr,glucose
CPK, aldolase, UA
Urine myoglobin
60 yo F c/o left arm pain that started while she was Angina/MI

ECG

swimming and was relieved by rest.

Tendinitis

CBC, XR-shoulder

Osteoarthritis

CXR
Stress test

45 yo F presents with low back pain radiates to the lateral Disk herniation

XR-L-spine

aspect of her left foot. The straight leg raise is positive. The Lumbar muscle str
patient is unable to tiptoe.

MR-L-spine

Tumor in the canal

45 yo F presents with low back pain that started after she Lumbar muscle stra XR-L-spine
cleaned her house. The pain does not radiate, and there is Disk herniation

MR

no sensory deficit or weakness in her legs. Paraspinal Vertebral

muscle tenderness and spasm are also noticed

compression frac

45 yo M presents with pain in the lower back and legs Lumbar stenosis

MRI,XR,CT

during prolonged standing and walking. The pain is Strain

Ankle-brachial

relieved by sitting and leaning forward.

index

Tumor in canal
Peripheral Vascu

17 yo M presents with low back pain that radiates to the Malingering

left leg and began after he fell on his knee during gym Strain
class. He also describes areas of loss of sensation in his left Disk herniation
foot. The pain and sensory loss do not match any known Knee fracture
distribution. He insists on requesting a week off from Ankylosing
school

spondylitis

XR,MRI