A 26-year-old woman is evaluated for progressively worsening headaches that began intermittently 6 months ago and became daily 3 months ago. The patient describes bilateral “vise-like” pain that is steady, moderate in intensity, and unaffected
A 28-year-old woman is evaluated after a 4-hour self-limited episode of palpitations. The symptoms occurred while at work yesterday.
A 62-year-old woman is evaluated for multiple areas of scaling and rough skin on her forehead and cheeks, the backs of her hands, and forearms. These areas are painless but persist despite application of moisturizer. She is in good overall health
A 60-year-old man is evaluated for new-onset monocular cloudy vision of the left eye that began 4 hours ago. He has type 2 diabetes mellitus and coronary artery disease. His current medications are aspirin, simvastatin, lisinopril, metoprolol, and
Test Yourself MKSAP image 2010, American College of Physicians, Medical Knowledge Self-Assessment Program (MKSAP.
The left panel of this angiography shows thrombosis of the right carotid artery such as might occur in a patient who presents to the emergency department with an acute symptomatic ischemic stroke. The right panel demonstrates the return of vascular
A 37-year-old woman is evaluated for an episode of blood in her urine. She notes the passage of red-colored urine that resolved spontaneously and was not associated with her menstrual cycle. She reports having had several similar episodes in the past
A 65-year-old man is evaluated because of painless neck swelling and difficulty swallowing that has progressively worsened over the last year. He does not have hoarseness, but he feels as though his voice is not as strong as it was in the past.
Vaginal pH is 6.0, “whiff” test is positive. Results of saline microscopy are shown. ... A urine pregnancy test is negative. MKSAP photo (c) American College of Physicians.
A 22-year-old man is evaluated for a skin eruption on his leg. The patient lives in Virginia and is active outdoors. One week ago, he found a black tick on his lower leg, which his roommate removed with a tweezers. Yesterday he developed diffuse