Beyond the Pearls: Cases for Med School, Residency and Beyond

Today's Case A 56-year-old male presents to the emergency department with complaints of fevers and chills for the past 3 weeks. Other review of systems is negative for headache, cough, shortness of breath, abdominal pain, dysuria, urinary frequency or urgency, or back pain. Vital signs reveal his temperature is 102.4°F, pulse rate is 118/min, blood pressure is 154/80 mm Hg, and respiration rate is...

Today's Case A 63-year-old female presents to the emergency department (ED) with sudden onset of difficulty speaking. The symptoms began approximately 1 hour earlier during dinner with family when her speech became slurred and incomprehensible. Due to her difficulty speaking in the ED, she is unable to provide additional information. Per her husband, her past medical history is notable for coronar...

Today's Case A 79-year-old male from Laos presents to the emergency department with nodules on his left lower extremity that have been slowly enlarging and spreading up his leg for 1 year. He reports weight loss and fatigue and denies any other systemic symptoms. He had just relocated from Laos to the United States. His medical history is generally unknown and he is not on any medications. Today's...

Today's Case A 77-year-old male with a history of sick sinus syndrome status post pacemaker placement, ulcerative colitis, hypertension, and type 2 diabetes mellitus was referred by his primary medical doctor for jaundice and pruritus. His doctor noted newly elevated liver enzymes alkaline phosphatase (ALP) 672 U/L, total bilirubin (BR) 5.0 mg/dL, alanine aminotransferase (ALT) 77 U/L, and asparta...

Today's Case A 70-year-old healthy female was referred to the dermatology clinic for a crusted erythematous thin plaque on her left nipple. It has been present for 1 year and is associated with intermittent pruritis. She had seen her primary care physician for this and was prescribed a topical antifungal cream and powder. The rash has not improved. Today's Reader Jared Fehlman is an Internal Medic...

Today's Case A 60-year-old female with a history of type 2 diabetes mellitus, hypothyroidism, and hypercalcemia complicated by recurrent nephrolithiasis and recurrent urinary tract infections presents to the emergency department from her urology appointment with a blood pressure of 80/34 mmHg. Over the past few months, she has also experienced a 60 lb weight loss, shortness of breath, and generali...

Today's Case A 10-year-old boy presents to the clinic with his parents. They describe how he refuses to accept adult authority. He is easily annoyed and often loses his temper over small disappointments. The boy has already been suspended from school after hitting a teacher who was trying to restrain him when he refused to take a test and then ran out of the classroom and toward a busy street. Tod...

Today's Case A 25-year-old man presents to the sleep clinic with his wife, who reports that the patient has been having disturbing nightmares that wake him up from his sleep for the past 2 months. He does not recall these episodes and is only aware of them because his wife has been complaining about his abnormal behavior at night. He works in a marketing company and admits to an increased level of...

Today's Case A 23-year-old graduate student, who is in her first semester of pharmacy school, presents to the student mental health clinic at the request of her parents. She complains of having consistent problems turning in assignments on time and is now failing several classes. This has caused more stress, which only seems to be worsening the problems she is having with school. She is spending a...

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About Dr. Raj Dr. Raj Dasgupta is an ABIM Quadruple board-certified physician specializing in internal medicine, pulmonology, critical care, and sleep medicine. He is currently the Associate Program Director of Internal Medicine Residency at Huntington Health in Pasadena, California and an Associate Professor of Clinical Medicine for the University of California, Riverside School of Medicine (UCR)...

About Dr. Raj Dr. Raj Dasgupta is an ABIM Quadruple board-certified physician specializing in internal medicine, pulmonology, critical care, and sleep medicine. He is currently the Associate Program Director of Internal Medicine Residency at Huntington Health in Pasadena, California and an Associate Professor of Clinical Medicine for the University of California, Riverside School of Medicine (UCR)...

About Dr. Raj Dr. Raj Dasgupta is an ABIM Quadruple board-certified physician specializing in internal medicine, pulmonology, critical care, and sleep medicine. He is currently the Associate Program Director of Internal Medicine Residency at Huntington Health in Pasadena, California and an Associate Professor of Clinical Medicine for the University of California, Riverside School of Medicine (UCR)...

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠⁠⁠ ⁠...

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠...

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr....

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr....

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr....

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr....

Today's Case A 53-year-old woman presents with difficulty falling asleep and excessive daytime sleepiness for the past 6 months. She had a well-woman examination approximately 8 months ago, which was significant for diet-controlled diabetes mellitus type II (DMII) and Graves’ disease status post radioiodine ablative therapy. The remainder of her examination and all laboratory tests, including hemo...

Today's Case A 28-year-old female presents to an outpatient psychiatry clinic with a 1-month history of anxiety attacks. She has a past history of major depressive disorder (MDD) and is taking a low dose sero- tonin norepinephrine reuptake inhibitor (SNRI). During the panic attacks she experiences severe anxiety with the following symptoms: lightheadedness, accelerated heart rate, chest pain, shor...

Today's Case A 63-year-old male is brought in by ambulance to the emergency room for new onset weakness and confusion. His last known well time was 1 hour before presentation. He was having dinner with his family when suddenly he developed weakness and confusion, and the family called 911. He has a past medical history of type 1 diabetes, hypertension, and a strong family history of cerebral infar...

Today's Case A 61-year-old male arrives at the emergency department by ambulance after being in a three-vehicle collision resulting in two fatalities. After the event he is openly joking about the accident, appears apathetic to the loss of life, and has urinary incontinence while speaking to the police. Field sobriety tests are conducted by the police in response to his behavior. The test is quick...

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠ ⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠ ⁠⁠⁠⁠Dr. Raj o...

About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠ ⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠ ⁠⁠⁠Dr. Raj on Ins...