Internal Medicine Casebook. Real Patients, Real Answers 

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• 2. Editors and Authors

• 3. Preface

• 4. 1 - Allergy and Clinical Immunology

• 5. 2 - Cardiology

  Mr. S’s BP is 90/60 mmHG, HR is 112 bpm, respirations are 12. You begin an IV with normal saline and start O2 at 3L per cannula symmetric t wave inversion normal qt interval murmur pitting edema pathophysiology for icu patients

• 6. 3 - Endocrinology, Metabolism, and Diabetes

  casebook suggested answers pharmacotherapy Explain why thyroid function tests should be evaluated in a patient with primary adrenal failure? A 60-year-old man is hospitalized because of severe nausea, vomiting, and diarrhea of 4-days duration Explain why thyroid function tests should be evaluated in a patient with primary adrenal failure early hypopituitary axillary hair loss misdiagnosis A 60-year-old man is hospitalized because of severe nausea, vomiting, and diarrhea of 4-days duration. He admits to having experienced mild increasing fatigue and malaise for the past 6 months, plus poor appetite, frequent abdominal cramps, and a 20-pound (9-kg) weight loss over the past 4 months. He feels dizzy in the morning and lightheaded after standing for more than an hour. He notes that he tends to take a nap in the later afternoon. Four days before, abdominal cramps, vomiting, and diarrhea developed. He denies any skin changes and prolonged sun exposure. He admits to a decline in sexual desire. He has no history of hypertension, diabetes, asthma, or tuberculosis, and takes no medications. subunit level may be helpful as a tumor marker because some GH tumors cosecrete other pituitary hormones. corticosteroids postoperative hypoadrenalism atrophy adrenal cortex acth

• 7. 4 - Gastroenterology

  A 37-year-old housewife reports 3 weeks of general fatigue, several days of dark urine, and 1 day of scleral icterus. She denies vomiting, but complains of mild, continuous pain in the right upper quadrant, and intermittent nausea A 37-year-old housewife reports 3 weeks of general fatigue, several days of dark urine, and 1 day of scleral icterus. She denies vomiting, but complains of mild, continuous pain in the right upper quadrant, and intermittent nausea. Physical examination reveals the patient to be jaundiced but comfortable. She shows no signs of malnutrition and has no spider angiomas or palmar erythema. The liver is tender and measures 15 cm by percussion in the midclavicular line, it is palpable 4 cm below the costal margin on inspiration. The spleen is not palpable, and the examination findings are otherwise unremarkable a 42-year-old man is brought to the emergency room by ambulance Crohn Disease presents to you 4 months after she had 120 cm of distal ileum removed. She is complaining of flatulence and loose stools

• 8. 5 - Geriatrics

• 9. 6 - Infectious Diseases

• 10. 7 - Hematology and Oncology

  follicular lymphoma markers CD20, BC12, Ki67

• 11. 8 - Pulmonology

• 12. 9 - Nephrology

  A 65-year-old diabetic woman presents to the emergency room with right upper quadrant pain that radiates around to the back, together with nausea, vomiting, anorexia, lightheadedness, and a diminished urine output over the past 24 hours. • What is the most common cause of the secondary nephrotic syndrome in adults in the United States? In patients with this disorder, which early finding serves as a harbinger for the subsequent development of nephrotic syndrome and renal insufficiency? • What features of the history and physical examination are important in determining if this patient has a primary (idiopathic) or secondary form of the nephrotic syndrome? • What additional laboratory tests would you order either to establish or refute a secondary cause of the nephrotic syndrome? • How should this patient s evaluation proceed? A 40-year-old woman is referred for evaluation of proteinuria. The Internal medicine casebook 65-year-old woman who presents to the ER with right upper quadrant pain that radiates around to the back, together with nausea, vomiting, anorexia, light-headedness, and

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