topic_id int64 1 75 | year int64 2.02k 2.02k | patient_description stringlengths 337 1.29k |
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1 | 2,021 | Patient is a 45-year-old man with a history of anaplastic astrocytoma of the spine complicated by severe lower extremity weakness and urinary retention s/p Foley catheter, high-dose steroids, hypertension, and chronic pain. The tumor is located in the T-L spine, unresectable anaplastic astrocytoma s/p radiation. Compli... |
2 | 2,021 | 48 M with a h/o HTN hyperlipidemia, bicuspid aortic valve, and tobacco abuse who presented to his cardiologist on [**2148-10-1**] with progressive SOB and LE edema. TTE revealed severe aortic stenosis with worsening LV function. EF was 25%. RV pressure was 41 and had biatrial enlargement. Noted to have 2+ aortic insuff... |
3 | 2,021 | A 32 yo woman who presents following a severe 'exploding' headache. She and her husband report that yesterday she was in the kitchen and stood up and hit her head on the corner of a cabinet. The next morning she developed a sudden 'exploding' headache. She came to the hospital where head CT showed a significant amount ... |
4 | 2,021 | This is a 44 year old female with PMH of PCOS, Obesity, HTN who presented with symptoms of cholecystitis and was found incidentally to have a large pericardial effusion. A pericardiocentesis was performed and the fluid analysis was consistent with Burkitt's lymphoma. Pericardial fluid was kappa light chain restricted C... |
5 | 2,021 | 74M hx of CAD s/p CABG, EF 60% prior CVA (no residual deficits), HTN, HL, DMII, Moderate to Severe PVD was referred to cardiology for evaluation of PVD, and on examination patient was found to have carotid bruits. Upon further review of symptoms the pt reports + Occasional dizziness, no prior syncope occasional HA, Den... |
6 | 2,021 | Patient is a 55yo woman with h/o ESRD on HD and peritoneal dialysis who presented with watery, non bloody diarrhea and weakness. She has a history of 2 prior C diff infections, the most recent just 1 month ago. Recent antibx use in the last month on prior admission. Was also txd for Cdiff at that time for 14 d. course ... |
7 | 2,021 | 60 yo M with Hep C cirrhosis, grade II esophageal varices, recent admission for UGIB [**2-9**] NSAID gastritis, referred for admission throught the ED by hepatology clinic for new slurred speech and tangential thought process. Patient also describes new imbalance leading to a fall during which he may have hit his head ... |
8 | 2,021 | This is a 57-year-old gentleman with CLL and large cell transformation. He presented with his disease back in [**10/2119**] with an elevated white count and LDH. He was without any splenomegaly or any cytopenias at that time. He did have some bulky lymphadenopathy. He then completed four cycles of FCR therapy, which he... |
9 | 2,021 | 41 year old man with history of severe intellectual disability, CHF, epilepsy presenting with facial twitching on the right and generalized shaking in at his NH which required 20 mg valium to cease seizure activity. Per outside medical patient was felt to have focal epilepsy with secondary generalization, likely due to... |
10 | 2,021 | Pt is a 22yo F otherwise healthy with a 5 yr history of the systemic mastocytosis, with flares normally 3/year, presenting with flushing and tachycardia concerning for another flare. This is patient's 3rd flare in 2 months, while still on steroid taper which is new for her. She responded well to 125 mg IV steroids q 8 ... |
11 | 2,021 | A 75 yo M w/ metastatic papillary thyroid cancer s/p XRT 19 sessions who presented with 2 days of worsening dysphagia for solids, poor oral intake, weight loss 20 pounds over last several weeks and some lethargy.
Papillary thyroid cancer dx w/ right neck mass
--s/p neck mass resection; unable to perform thyroidectomy
-... |
12 | 2,021 | 34 year old woman with Marfan's syndrome and known severe mitral valve prolapse with regurgitation, who was planned for a MV repair but was lost to follow-up. She remains symptomatic and is now prepared to undergo mitral valve repair/replacement surgery. EF of 65% on TTE.
Past Medical History:
Marfans Syndrome
MVP wit... |
13 | 2,021 | 62 yo male with hx of CVA, neurogenic bladder with indwelling suprapubic catheter with multiple prior admissions for UTIs, altered mental status, and urosepsis presents to the hospital in urosepsis now resolved after treatment with vanc/meropenem. Per CT there is a non-obstructing stone in the L ureter, no evidence of ... |
14 | 2,021 | 70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and alter... |
15 | 2,021 | 70 year-old woman with a history of CAD recently noted abdominal mass who presents with fevers/rigors and bandemia. Over the last few weeks leading up to admission, she has been experiencing mid-abdominal pain, radiating to the left flank. It lasts throughout the day is not increased by eating though there is associate... |
16 | 2,021 | 79 yo F with multifactorial chronic hypoxemia and dyspnea thought due to diastolic CHF, pulmonary hypertension thought secondary to a chronic ASD and COPD on 5L home oxygen admitted with complaints of worsening shortness of breath. Cardiology consult recommended a right heart cath for evaluation of response to sildenaf... |
17 | 2,021 | 64yo woman with multiple myeloma, s/p allogeneic transplant with recurrent disease and with systemic amyloidosis (involvement of lungs, tongue, bladder, heart), on hemodialysis for ESRD who represents for malaise, weakness, and generalized body aching x 2 days. She was admitted last week with hypercalcemia and treated ... |
18 | 2,021 | This is a 78 year-old male with h/o BPH s/p multiple urological procedures, including s/p Suprapubic prostatectomy. He was noted to have low urine output and bladder scan showed 360cc residual. It was impossible for staff to pass a foley. Urology was consulted, performed a flexible cystoscopy in the ICU and found sever... |
19 | 2,021 | 65 yo man with history of CAD and prior MI, HLD, HTN, ventricular tachycardia, and syncope was admitted earlier today evaluation of syncope and ventricular arrhythmias. He was recently discharged after a negative work-up for syncope which included the implantation of a cardiac monitoring device. It was interrogated at ... |
20 | 2,021 | A 35-year-old woman presents with history of acne and mild hirsutism. The primary evaluation revealed elevated testosterone levels. She recently noticed gradual enlargement of her hands and feet and recognized that her ring is getting small for her finger. There is some irregularity in her menstrual cycle as well as so... |
21 | 2,021 | The patient is a 57-year-old man with abdominal pain and vomiting. The pain started gradually about 20 hours ago in the epigastric and periumbilical regions, radiating to his back. He drinks around 60 units of alcohol per week and smokes 22 cigarettes per day. He is healthy with no history of allergies or using any med... |
22 | 2,021 | The patient is a 31-year-old woman complaining of abdominal pain. The pain started last night as diffuse abdominal discomfort. She had poor appetite as well as malaise. The pain worsened in intensity and became sharp in the morning. The pain became localized to the right lower quadrant in the morning. The temperature i... |
23 | 2,021 | A 39-year-old man came to the clinic with cough and shortness of breath that was not relieved by his inhaler. He had these symptoms for 5 days during the past 2 weeks. He doubled his oral corticosteroids in the past week. He is a chef with a history of asthma for 3 years, suffering from frequent cough, wheezing, and ... |
24 | 2,021 | The patient is a 55 year old man visiting his primary care physician for lower urinary tract symptoms including frequency, urgency, weak stream, incomplete emptying and intermittent flow for the past 9 months. Further evaluation revealed:
IPSS score : 15
Post-void residual: 70 mL
Prostate volume (TRUS): 60 mL
Prostate-... |
25 | 2,021 | The patient is a 42 year-old postmenopausal woman who had a screening sonogram which revealed an abnormality in the right breast. She had no palpable masses on breast exam. Core biopsy was done and revealed a 1.8 cm infiltrating ductal breast carcinoma in the left upper outer quadrant. Lumpectomy was done and the surgi... |
26 | 2,021 | A 45-year-old woman was referred to the emergency department with abdominal pain lasting about 4 days accompanied by nausea and 2 episodes of vomiting. The pain is localized to the epigastric region and radiates to the right upper quadrant. The pain is worsening after eating fatty food. The patient experienced similar ... |
27 | 2,021 | A 53-year-old man presents with chronic HCV infection for the past 2 years. His past medical history is only significant for inguinal hernia surgery when he was 20 years old. He is on IFN (100 mg/week) plus RBV (400 mg/day) combination therapy for the past 9 months. Direct antiviral drugs were added to his treatment 6 ... |
28 | 2,021 | The patient is a 60-year-old Spanish man presenting with shortness of breath about a day before. The symptoms began acutely and progressively worsened. He is a known case of COPD since 2 years ago. The spirometry revealed post-bronchodilator FEV1/FVC = 60% of predicted values. He smokes 20 cigarette per day. His past m... |
29 | 2,021 | The patient is a 24-year-old man who has had type 1 diabetes for 11 years. He presents to the emergency room with hyperglycemia and concern for possible diabetic ketoacidosis after not taking his insulin for 3 days. The patient reports that he is currently homeless and has lost his supply of insulin, syringes, glucomet... |
30 | 2,021 | The patient is a 33-year-old woman complained of fatigue, weight gain and abnormal spotting between menses. No hirsutism or nipple discharge was detected. Her BMI was 34. Her lab results were remarkable for high TSH level (13 mU/L) and low free T4 level (0.2 ng/dl). Her anti-TPO levels were extremely high (120 IU/ml). ... |
31 | 2,021 | The patient is a 37-year-old woman who came to the clinic for a routine Pap smear. The test revealed stage 1B of cervical cancer. The patient tested positive for HPV 16. She has three sexual partners and four children. She underwent tubal ligation. She smokes 30 packs/year and drinks alcohol frequently. She is otherw... |
32 | 2,021 | A 17 year old boy complains of vomiting, non-bloody diarrhea, abdominal pain, fever, chills and loss of appetite for the past 3 days. He ate a salad at a restaurant prior to his diarrhea onset. Physical exam was remarkable for pallor, jaundice, and diffuse abdominal tenderness. Lab results were as follows:
Hemoglobin:... |
33 | 2,021 | A 42-year-old healthy woman came to the clinic to have her flu shot in early October. She works in a rehab center and has no underlying disease. It's her first time getting the vaccine this year. She is married for 5 years and uses barrier methods of contraception. Her menstrual cycle is irregular. She does not smoke... |
34 | 2,021 | The patient is a 47-year-old Asian woman complaining of persistent feelings of sadness. She lost interest in activities she used to enjoy. She states that her mood is mostly depressed for the past 3 weeks. She also lost her appetite , which led to about 5kg weight loss. She complains of loss of energy and feelings of w... |
35 | 2,021 | The patient is a 15 year old girl with the history of recurrent bilateral headache. The attacks come 2 times or more per week and each episode lasts around a day or a half. The pain is pulsating in quality and severe in intensity, causing trouble in her routine physical activity. The attacks are associated with nausea ... |
36 | 2,021 | The patient is a 32-year-old obese woman who came to the clinic with weight concerns. She is 165 cm tall and her weight is 113 kg. She is complaining of sleep apnea, PCO and dissatisfaction with her body shape. She is a high-school teacher married for 5 years. She doesn't use any contraceptive methods for the past 4 m... |
37 | 2,021 | The patient is a 20 year old Caucasian female presents to the clinic with one-sided vision lost and facial weakness, dysarthria and numbness lasting for 1 day. She visited her PCP and underwent brain MRI which revealed a single plaque in the brainstem. After few months, she experienced lower extremities weakness led to... |
38 | 2,021 | The patient is a 35-year-old woman with myasthenia gravis, class IIa. She complains of diplopia and fatigue and weakness that affects mainly her upper limbs. She had a positive anti-AChR antibody test, and her single fiber electromyography (SFEMG) was positive. She takes pyridostigmine 60 mg three times a day. But she ... |
39 | 2,021 | A 3-day-old Asian female infant presents with jaundice that started a day ago. She was born at 38w3d of gestation, after an uncomplicated pregnancy. The family history is unremarkable. The baby is breastfed.
Vital signs are reported as: axillary temperature: 36.3°C, heart rate: 154 beats/min, respiratory rate: 37 breat... |
40 | 2,021 | The patient is a 60 year old man complaining of frequent headaches, generalized bone pain and difficulty chewing that started 6 years ago and is worsening. Examination shows bilateral swellings around the molars. The swellings have increased since his last examination. Several extraoral lesions are detected in the he... |
41 | 2,021 | A 57-year old farmer was diagnosed with Parkinson's disease a year ago. He experiences slowness of movement and tremors. His past medical history is significant for hypertension and hypercholesterolemia. He lives with his wife. They have three children. He used to be active with planting and taking care of their farm a... |
42 | 2,021 | 19 yo Hispanic female G1P1 at 32+ 6 weeks of gestational age presented to the OB clinic for routine follow up complaining of mild headache and leg swelling. Primary evaluation revealed BP of 146/99 and urine dipstick with 3+ proteins. Her BP and U/A were normal in previous visit. Repeat BP a few hours later is 150/100 ... |
43 | 2,021 | The patient is a 60-year-old woman admitted to the stroke department with a recent history of a second course of intravenous antibiotics for aspiration pneumonia. She is febrile and complained of abdominal pain and diarrhea (bowel movements eight times in 3 hours, large volumes of greenish, liquid stool each time).
The... |
44 | 2,021 | The patient is a 14-year-old boy complaining of scoliosis and back pain. He has no other medical condition. He used to be able to play routine activities such as basketball and soccer, however, he recently has problem doing them. The pain is in his leg and back and aggravated by physical activities. He prefer lying dow... |
45 | 2,021 | The patient is a 34-year-old African American man with the known history of Sickle cell disease comes to the clinic with severe bone pain. The patient had severe pain in his lower back that radiated to both thighs scored 9 out of 10. The patient has had positive history of sickle cell crises since childhood. He also ha... |
46 | 2,021 | Patient A is a 30-year-old male who was admitted to the hospital after 10 days of cough, profuse nocturnal sweating and loss of appetite. He had traveled to India 1 months ago and has not any positive history of TB vaccination. He is a previously healthy man, working as an engineer in a high tech company. He doesn't sm... |
47 | 2,021 | A 62-year-old African-American man presented with left upper and lower extremity weakness, associated with dark visual spot in right eye, right facial numbness, facial drop and slurred speech. He denied dyspnea, headache, palpitations, chest pain, fever, dizziness, bowel or urinary incontinence, loss of consciousness. ... |
48 | 2,021 | Fernandez is a 41 year man who is a professional soccer player. He came to the clinic with itchy foot. Physical exam revealed localized scaling and maceration between the third and fourth of his right toe. It became inflamed and sore, with mild fissuring. The dorsum and sole of the foot was unaffected. There is no pus ... |
49 | 2,021 | A 12 year old girl came to the clinic with her mother, complaining of short stature, delayed in puberty and developmental delay. Her karyotype study revealed 45X and confirmed the diagnosis of Turner syndrome. She is treating with GH since 6 months ago without estrogen therapy to avoid menarche and reach the ideal heig... |
50 | 2,021 | A 5 months old male brought to the pediatrics surgery clinic with the complaint of empty scrotum at the right side. The baby boy is a first child who was born at the age of 38 weeks with NVD from a healthy mother. The mother had a normal pregnancy with no complication. The baby boy weighted 3200 gr with the height of 5... |
51 | 2,021 | The patients is a 25-year-old G1 P1 pregnant woman who is 24W3D gestational old who developed a sudden unset of fever and chills, accompany with nausea and vomiting. She also complains of dysuria, urgency and frequency. She also reports some severe pain in the flank. Her vital signs are: T = 39.7ºC, P = 117, R = 20, an... |
52 | 2,021 | A 34 year old man comes to the clinic complaining of dizziness and severe diarrhea since yesterday. He has returned from an international trip few days ago and was living in a camp in Sudan for a month. He developed abdominal pain followed by bloating and nausea as well as loose bowel movements. Soon he was having prof... |
53 | 2,021 | Patient is a 34-year-old woman from Jordan who comes to clinic with some general and non-specific bones and joints pain. She is married and has 3 children. Her past medical and drug history are unremarkable. Her BMI is 23, BP: 120/75, HR: 75/min. Her laboratory study is remarkable for Vit D: 14ng/ml and otherwise healt... |
54 | 2,021 | A 57-year-old man was admitted to the clinic because of weight loss and persistent dry cough 4 months ago. Chest computed topography showed bilateral multiple infiltrates in the upper lobes and thickened bronchial walls. There is a documented positive serum MPO-ANCA in his medical record. Transbronchial biopsy revealed... |
55 | 2,021 | A 22-year-old Caucasian man came to the Clinic with a history of tremors since a year ago. The tremor was first in his right hand while holding something. Later the tremor became continuous and extended to both hands and legs and even at rest. The Kayser-Fleischer' ring was detected in the ophthalmologic exam. The phys... |
56 | 2,021 | The patient is a 41-year-old man and a known case of Acromegaly who underwent transsphenoidal surgery 4 months ago. He came to the clinic for the follow up lab studies after his primary resection surgery. His lab study shows the IGF-1 level of 4.5 ULN adjusted by sex and age. His random GH level is 4 ug/L. The recent b... |
57 | 2,021 | The patient is a 41-year-old obese woman coming to the emergency room with abdominal pain and vomiting. The pain that started gradually yesterday is located in the epigastric and periumbilical regions, radiating to her back. She drinks alcohol frequently and does not smoke. She has no history of allergies and uses only... |
58 | 2,021 | The patient is a 17-year-old boy complaining of severe migratory pain in the right lower quadrant of his abdomen that started four days ago. The pain is accompanied by nausea and vomiting. He was febrile with tenderness, rebound tenderness and guarding on palpation. His WBC was elevated with dominant neutrophils. CT sc... |
59 | 2,021 | The patient is a 15-year-old boy with asthma diagnosed a year ago. He presents with shortness of breath, chest tightening and cough. According to his mother, he didn't respond to the usual corticosteroid inhaler. He was admitted to the emergency department with diagnosis of severe asthma exacerbation. He is a candidate... |
60 | 2,021 | The patient is a 63-year-old man presenting to the Emergency Department with a history of acute urinary retention in the past 2 days. Abdominopelvic CT scan revealed a large prostate and a bladder filled with urine. He is a candidate for urethral catheterization and TURP. Further evaluation revealed:
Post-void residual... |
61 | 2,021 | The patient is a 45-year-old postmenopausal woman with cytologically confirmed breast cancer. A core biopsy revealed a 3 cm invasive ductal breast carcinoma in the left upper outer quadrant. The tumor is HER2-positive and ER/PR negative. Axillary sampling revealed 5 positive lymph nodes. CXR was remarkable for metasta... |
62 | 2,021 | A 46-year-old man presents with dizziness and frequent headaches. He has a family history of CAD, but no other cardiovascular risk factors such as smoking, high blood pressure, and diabetes mellitus and is physically active. The patient's LDL-C and HDL-C levels were 545 and 53 mg/dL, respectively. His fasting glucose a... |
63 | 2,021 | A 54-year-old obese woman admitted to the emergency department with abdominal pain that started 4 days ago with nausea and vomiting. The epigastric pain radiates to the right upper quadrant, getting worse after eating fatty food. The patient experienced similar pain twice in the past year. Her past medical history is r... |
64 | 2,021 | The patient is a 55-year-old man diagnosed with HCV 2 years ago and the recent coinfection with HBV. His past medical history is non-significant. He is on IFN, RBV and direct antiviral drugs for the past 6 months. The patient takes no other medications. His medical records show previous positive HCV RNA tests and a pos... |
65 | 2,021 | The patient is a 25-year-old man with type 1 diabetes confirmed with molecular analysis 7 years ago. He presents to the clinic with shortness of breath and fatigue during activities. He claims mild dyspnea after climbing 3 floors, no dyspnea at rest and no angina (New York Heart Association class 2). He is diagnosed wi... |
66 | 2,021 | A 16-year-old girl came to the clinic complaining of weight gain and abnormal menstrual cycles. Her BMI was 24, but she has gained 5 kg in the past few weeks. She gets tired more frequently and does not have energy to go dancing with her friends. Her lab results were remarkable for high TSH levels (15 mU/L) and low fre... |
67 | 2,021 | A Pap smear in a 54-year-old woman revealed abnormal cervical squamous intraepithelial/glandular lesion. She tested positive for HPV 16. She is sexually active with her husband and has 4 children. She is menopausal and uses no contraception. She smokes and drinks alcohol frequently. She is otherwise healthy. She was of... |
68 | 2,021 | The patient is a 23-year-old man who came to the hospital with high blood pressure (175/95 mmHg) and signs of septicemia. He developed respiratory failure requiring mechanical ventilation and renal failure requiring hemodialysis. His blood smear showed microangiopathic hemolytic anemia and thrombocytopenia. His blood t... |
69 | 2,021 | A 67-year-old healthy woman came to the clinic to have her flu shot in early October. She works at a rehab center and has no underlying disease. It is her first vaccination this year. she is menopausal and has 4 children. She does not some. She takes daily multivitamins and anti-hypertensive drugs. She exercises regula... |
70 | 2,021 | A 46-year-old Asian woman with MDD complains of persistent feelings of sadness and loss of interest in daily activities. She states that her mood is still depressed most of the days. She complains of loss of energy and feelings of worthlessness nearly every day. She is on anti-depressants for the past 6 months, but t... |
71 | 2,021 | The patient is a 34-year-old obese woman who comes to the clinic with weight concerns. She is 165 cm tall, and her weight is 113 kg (BMI: 41.5). In the past, she unsuccessfully used antiobesity agents and appetite suppressants. She is complaining of sleep apnea, PCO and dissatisfaction with her body shape. She is a h... |
72 | 2,021 | The patient is a 16-year-old girl recently diagnosed with myasthenia gravis, class IIa. She complains of diplopia and weakness affecting in her upper extremities. She had a positive anti-AChR antibody test, and her single fiber electromyography (SFEMG) was positive. She is on acetylcholinesterase inhibitor treatment co... |
73 | 2,021 | The patient is a 3-day-old female infant with jaundice that started one day ago. She was born at 34w of gestation and kept in an incubator due to her gestational age. Vital signs were reported as: axillary temperature: 36.3°C, heart rate: 154 beats/min, respiratory rate: 37 breaths/min, and blood pressure: 65/33 mm Hg.... |
74 | 2,021 | The patient is a 53-year-old man complaining of frequent headaches, generalized bone pain and difficulty chewing that started 6 years ago and is getting worse. Examination shows bilateral swellings around the molars. The swellings have increased since his last examination. Several extraoral lesions of the head and f... |
75 | 2,021 | The patient is a 55-year-old man who was recently diagnosed with Parkinson's disease. He is complaining of slowness of movement and tremors. His disease is ranked as mild, Hoehn-Yahr Stage I. His past medical history is significant for hypertension and hypercholesterolemia. He lives with his wife. They have three chil... |
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