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Title Specialty Votes Comments Rating

Indurated skin plaques

Hi to all, I apologize ahead of time as I do not have all the info needed handy this time, but I saw a case last week in the office that made me th...		 Dermatology 82 102

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

lyme's disease?

isaw a 45 year old male 3 weeks ago complaining of feeling fatigued for the past 2-3 months. he had seen my colleague the week prior and had requested a...		 Family Medicine 89 38

aspirin offers no primary cardiac protection in diabetes?

New study: 1300 pts type 1 or 2 diabetics with asymptomatic PVD followed for 7 years. No difference between the groups on composite primary outcomes: CHD ...		 Internal Medicine 62 99

What to do about viridans Strep in a newborn?

In my hospital, I sometimes admit well-appearing newborns due to fever (typical "48-hour rule out sepsis") on IV ampicillin and cefotaxime or gentamycin) in...		 Infectious Diseases 28 98

Clinical significance of spinal arachnoiditis?

I have a patient with chronic back pain which has been intractable for 20+ years. I inherited her on 160mg of methadone daily and a fishy story of injuries ...		 Neurosurgery 94 53

Sermo Case Conference in Neurology: 42 YO male with headache

HPI: A 40-year old man presented with severe headache which beganabruptly one month previously and persisted almost on a daily basiswith varying intensity....		 Case Conference 58 78

Sermo Case Conference in Radiology: 75 YO F with neck pain

CC: 75 y.o. female with persistent neck pain for one month.HPI (including ROS): 75 y.o. female with history of seropositive rheumatoid arthritis with one mo...		 Case Conference 88 54

Sermo Case Conference in Urology: 54 YO M c Metastases

This is the story of a very unfortunate 54 year old white male who presented with new onset confusion, headaches, and pain.PMH revealed avascular necrosis o...		 Case Conference 7 14

Elevated tumor markers in pregnant pt. with h/o breast ca

My 1st post-32yo LAF with h/o of T1N3b ER-PR-Her2- Left IDC Breast dx 9/05 with 15/22 LN+. She underwent lumpectomy with clear margins, adjuvant FEC/tax...		 Oncology 79 96

Abnormal preop EKG in woman for shoulder surgery

56 y/o WF, 5' 4", 189 pounds, to have shoulder surgery tomorrow. I saw her six days ago. She has hx HTN, migraines, kidney stones, colon ca. Had multiple la...		 Anesthesiology 13 88

Laparoscopic hysterectomy - Is it worth the time and risk?

I have been reviewing our reimbursements for procedures lately and am again appalled by the lower payments for laparoscopic surgeries which take more time and e...		 OBGYN 28 32

Return to play after concussion

Saw a young man today (17 years old). Suffered concussion Friday night playing football. Had some amnesia, headaches, altered vision, and vomitting after t...		 Family Medicine 66 56

PE, cardiac arrest and thrombolytics

Had a 56 year old patient who came in by ambulance with the main complaint of SOB. His wife actually called ahead to the ER before she called 911 asking fo...		 Emergency Medicine 6 27

C. Dificile in 3 month old - anyone else seen this?

Had a 3 month old who had profuse diarrhea after being put on plain Amoxil. Stool culture done by my partner showed C. dif. Saw baby today and mom states he...		 Family Medicine 50 12

Sermo Case Conference in IM: 19 YO F with jaundice

Chief Complaint: abdominal painHistory of Present Illness: 19/F c/o nausea, vomiting, diffuseabdominal pain x 2 weeks. She denied hematemesis,diarrhea/...		 Case Conference 99 82

Sermo Case Conference in Economics: Restrictive Covenants

Many physicians, both fresh out of training and those leaving a self-employed private practice, are contracting to be employed physicians. Most commonly th...		 Case Conference 21 84

Sermo Case Conference in Neurology: 45 YO M c visual deficit

History of presenting illnessHe reports that he cannot see well on his right side. This was first noticed 2 months back, but has been progressive. He had be...		 Case Conference 54 38

Sermo Case Conference in Psychiatry: 60 YO F c Depression

CC: "I've been depressed."HPI: Janet is a self-referred 60 y/o dwf with no previous psychiatric visits who reports depressed mood, lack of interest, poor...		 Case Conference 5 81

Sermo Case Conference in ID: 54 YO male with abdominal pain

CC: abdominal pain for two days HPI: 54 y/o Male h/o poorly controlled Diabetes Mellitus type 2 presenting with RLQ and epigastric abdominal pain for 2...		 Case Conference 78 61

Sermo Case Conference in Pain Medicine; 79 yo w back pain

A 79 year old female, GB, presents through the ER to the family medicine service of a suburban hospital after a slip and fall at home. She is a mildly tangen...		 Case Conference 23 67

5 week old with history of fever at home

CC- feverHPI- mother measured an axillary temperature at home at 100.5PMH- Child has been on amoxicillin for 8-9 days for congestion and some postauricu...		 Emergency Medicine 22 14

RLQ pain, good story for appy, negative CT- what do you do?

41 year old woman presented with epigastric pain started earlier today and nausea, pain gradually migrated to RLQ. Afebrile, exam with McBurney's point ten...		 Emergency Medicine 93 49

Confusing and Unusual Clinical Presentations

I recently saw a 58 year old female who developed "restless leg syndrome" approximately 8 years ago. She stated the condition started suddenly one evening ...		 Internal Medicine 9 9

Tumor board - synchronous cancer of the tonsil and lung

Quick question (yeah, right)I have a patient with a T3N0 cancer of the tonsil with mixed histology - squamous and small cell (++ yes, small cell of the ...		 Oncology 86 101

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