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Title Specialty Votes Comments Rating

61 year old female with Fever, Nausea

HOPI (including ROS): 61 year old white female, DM2, HLD, presents to emergency room after 3 days of progressively worse nausea and vomiting.She recently re...
Case Conference 25 52

Case Conference in OB/GYN: 29 y/o female with abnormal PAP

The pt is a 29 y/o G0 P0 wf who initially presented with complaints of LLQ pain. Abdomen was soft with no point tenderness. Pelvic exam revealed no cervical mo...
OBGYN 15 7

Sermo Case Conference in Pediatrics:9 YO F c fevers and rash

CC: fever and rashHPI, including ROS: The patient is a 9 year old female who presents with fever and rash for 1 week. She was in her usual state of good...
Pediatrics 95 75

56 YO M c metastatic SCLC

CC:Partial response to chemotherapy. Sent for consideration of prophylactic cranial irradiationHPI: 56 y/o male who presented with cough and hemoptysis 5/2...
Oncology 78 56

Another revision hip?

This time I have a 60 yo lady with bilateral hybrid THA 10 years ago. Now with bilateral groin pain L>R, asymmetric poly wear, occ L thigh pain. The kicke...
Orthopaedics 66 91

treatment of WIlliams Syndrome

I've been struggling with a patient with williams syndrome; his family asked that i see him as a second opinion.he's now 23; since the age of 6, he'd been ...
Psychiatry 67 63

77 yo for hemicolectomy w/ paroxysmal a-fib w/ rate of 127.

the above gentleman shows up in preop having been seen by an internist 2 days prior for preop eval. it was noted he was in a-flutter w rate of 125. placed...
Anesthesiology 86 68

Surgery following CRPS Type 1

I received an interesting consult today from a plastic surgery colleague. This is a patient that I saw over the summer. She is a 57 yo women with IDDM, HTN. ...
Pain Medicine 93 73

7 Year-Old with Fatigue and Taste Problems

I saw a new 7 year-old, previously healthy, male patient for a 1 week history of mild headache, fatigue and decreased PO secondary to bad taste of EVERYTHING ...
Pediatrics 99 8

Tumor Board - Large Cell Lymphoma of the Colon - stage IE

70ish previously healthy man with no risk factors, presents with vague abdominal complaints, and CT suggests a mass in the cecum.The mass is not clearly...
Oncology 72 59

the new ACCP 8 guidelines for DVT and PE

I am curious how many people have read through the new guidelines recently published by the American College of Chest Physicians with regard to DVT and PE treat...
General Interest 42 52

Generic OCPs - decreased efficacy relative to brand?

I recently had a discussion with a non-academic family planning colleague. He and a few of his colleagues believe strongly that generic birth control pills...
OBGYN 18 40

Incidental hypermobile cecum - optimal management?

I've run into this several times in the course of doing appendectomies, and can't seem to find the precise recommendation for what to do. What is your common p...
Surgery 100 96

3 month old with poor suck (unoffical case)

As a pediatric hospitalist at a 30-bed suburban pediatric ward outside Los Angeles, I get a call from a local hospital with a small (4-bed) pediatric ward, ...
Pediatrics 27 95

temporal arteritis and spike in lfts

I recently diagnosed temporal arteritis, proven by biopsy and by a dramtic response to prednisone, in a 65 yr old man who also had elelvated lfts. I apprec...
Rheumatology 74 24

Patient with history stent placement now with TIA or CVA

Hypothetical patient:68 y/o wf hx of drug-eluting RCA stent placement 6 month ago and left circumflex stent 2 years ago presents with classic presentati...
Hospitalist 33 83

Allergic immunotherapy and decreased spirometry

I have a young female asthmatic who has been very well controlled with albuterol prn and advair during the summer. She has had 2 normal pfts and many normal off...
Allergy and Immunology 47 10

23 months old walking abnormal

23 months male,mother said he holds his belly while walking, looks like he has pain in his abdomen, for about 2 weeks, and also bends forward( which he was ...
Pediatrics 83 29

Panhypopit or Adrenal or OCP???

Please help me with this case. I'm not sure where to go next.36yo C female with complaints of abdominal pain, loose BMs/diarrhea. No weight loss or fe...
Family Medicine 92 7

complex hyperplasia without atypia in breast cancer patient

I recently had a patient that I wanted to ask the community about. I was a bit surprised about the recommendation from the gynecologic oncologist th...
OBGYN 35 48

60 y/o M prostate ca, nadir 3.8 after radiation- what to do?

I have a patient who is now 60 y/o. He presented with T1c, Gl 6, PSA 11.8 prostate cancer. Tx EBRT to 45Gy + I125 seed implant. 4/2/07PSA values: 7/07- 5...
Oncology 77 55

Sermo Case Conference in OB: 41 YO Pregnant F with high B/P

This 41 yo G2P1 WF was seen at 33 6/7 weeks by good dates (first visit and U/S at 7 weeks) in the clinic, where her B/P was 160/105. She had been on bedrest at...
Case Conference 20 22

Sermo Case Conference in Neurology: 46YO F c gradual hemiparesis

CC: gradual R sided hemiparesisHPI:A 46 year old Caucasian female, a schoolteacher, with no significant past medical history, had arthroscopic surgery f...
Case Conference 13 56

Sermo Case Conference in Pediatrics: Newborn with Rash

CC: Newborn presents in delivery room with a rash HPI (including ROS): A Full Term Female was born to 20yo G1P1 mother who is A+, rubella...
Case Conference 95 8

Stump appendicitis

23 year old male status post laprascopic appendectomy 5 months ago. Diagnosed by CT scan with stump appendicitis. Fecalith was also noted. What is the be...
Surgery 13 66

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