The 62nd meeting: "Beating, Fast and Slow"

jc0724.mp3 Ciao, this is Hakodate Ryouhoku Hospital. I'm Dr. Daisy. Today we present an abstract of the CLINICAL PROBLEM-SOLVING article, “Beating, Fast and Slow". A 52-year-old man presented to his primary care physician with a 2-week history of exertional chest discomfort, described as a sensation of fullness in the center of his chest without radiation, and dyspnea. Exertional chest discomfort and dyspnea in this age group are most worrisome for cardiac causes, particularly myocardial ischemia. Other cardiac diseases that need to be considered are bradyarrhythmias, heart failure due to cardiomyopathy, valvular heart disease, and acute myocar…

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The 61st meeting: "A Patient with Migrating Polyarthralgi…

25901693.mp3 Ciao, this is Hakodate Ryouhoku Hospital. I'm Dr. Daisy. Today we present an abstract of the CLINICAL PROBLEM-SOLVING article, “A Patient with Migrating Polyarthralgias". A 28-year-old woman with no clinically significant medical history presented to the emergency department for evaluation of fatigue and joint pain. She initially noted pain and swelling in her right foot and ankle, which limited her ability to walk. These symptoms persisted for several days and then resolved, but pain in her knees and hips then developed, along with swelling and pain in her right elbow. She had not had a recent cough or sore throat but reported havin…

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The 60th meeting: "Weak in the Knees"

JC060b.mp3 Ciao, this is Hakodate Ryouhoku Hospital. I'm Dr. Daisy. Today we present an abstract of the CLINICAL PROBLEM-SOLVING article, “Weak in the Knees". A 61-year-old woman presented to her primary care physician with a 4-week history of progressive bilateral leg weakness, bilateral leg pain, and difficulty walking. The weakness was symmetric, without exacerbating or ameliorating factors, and did not fluctuate during the course of the day. The patient also reported depression, anxiety, memory problems, and intermittent headaches that had begun several months earlier. She had a dry mouth but no difficulty swallowing. Dry mouth is nonspe…

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