The 58th meeting: "Spiraling Out of Control"

jc058b.mp3 Ciao, this is Hakodate Ryouhoku Hospital. I'm Dr. Daisy. Today we present an abstract of the CLINICAL PROBLEM-SOLVING article, “Spiraling Out of Control". A 22-year-old man presented to the emergency department on Christmas Day with a 5-day history of myalgias, cough, dyspnea, nonbilious emesis, and nonbloody diarrhea. Although he had been ill for several days, he ultimately sought treatment because of intractable vomiting. He reported feeling feverish, although he had not measured his temperature, and noted one episode of hemoptysis. The presence of hemoptysis should broaden the differential diagnosis to include aggressive pathog…

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The 57th meeting: "Venting the Spleen"

JC058.mp3 Ciao, this is Hakodate Ryouhoku Hospital. I'm Dr. Daisy. Today we present an abstract of the CLINICAL PROBLEM-SOLVING article, “Venting the Spleen". A 19-year-old woman presented to a community hospital with a 4-day history of abdominal pain, located in the right upper quadrant and epigastrium, with occasional radiation to her back. She reported no fever, sweats, jaundice, dyspnea, vomiting, diarrhea, constipation, urinary abnormalities, joint aches, or rash. The patient had a history of hereditary spherocytosis. Ten years earlier, she had undergone laparoscopic splenectomy and cholecystectomy for chronic hemolytic anemia with symptomat…

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The 56th meeting: "A Curious Case of Chest Pain"

JC056.mp3 Ciao, this is Hakodate Ryouhoku Hospital. I'm Dr. Daisy. Today we present an abstract of the CLINICAL PROBLEM-SOLVING article, “A Curious Case of Chest Pain". A 67-year-old man presented to the emergency department with chest pain, reporting that he had felt well until 10 days before presentation, when nausea, nonbloody emesis, bloating, and epigastric pain developed. Over the course of several hours on the day of presentation, heaviness of the chest developed on exertion and progressed to pain at rest accompanied by diaphoresis and dyspnea. The level of creatine kinase was 182 U per liter, the creatine kinase MB fraction 17.4 ng per mill…

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