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Consultant Vol 44 No 9

A 30-year-old man presented
with severe left flank
pain radiating to his abdomen
and gross hematuria
of 5 to 10 days’ duration.
He also reported a 4- to 6-month
history of nausea with intermittent
vomiting, anorexia, and progressive
weight loss. He took no medications
and had no allergies.

A 72-year-old woman presented for evaluation of a large swelling on
her dorsal wrist, which had been present for 2 years. The protuberance
was not painful or tender; the patient was otherwise in good

This 10-year-old boy presented for
evaluation of a rash that developed
during a spring vacation on Florida’s
Atlantic coast. After he had been
swimming in the ocean, a pruritic,
erythematous, papular rash developed
on his trunk, axillae, and groin. Approximately
24 hours after the onset
of the rash, he experienced malaise,
chills, and a sore throat. His past medical
history was unremarkable. He
had been fully immunized and had
had varicella infection.

Clavicle fractures in the pediatric population are very common. Clavicle fractures in the pediatric population are very common. Clinical manifestations include decreased movement of the arm on the affected side, crepitus, and/or bony irregularity at the fracture site. Here, a review of fracture in newborns and older children.

A 60-year-old woman with hypertension, diabetes mellitus, and intermittent
atrial fibrillation presents with nausea, diaphoresis, dizziness, and global
weakness that has lasted 1 hour. She denies chest pain, dyspnea, syncope,
vomiting, diarrhea, blood loss, and headache; there is no vertigo. Medications
include acetaminophen, digoxin, diltiazem, glipizide, hydrochlorothiazide,
irbesartan, metformin, pioglitazone, and warfarin.

Scrotal enlargement and pain of rapid onset prompted a 28-year-old man to seek medical attention.
The testicle was displaced posterior and inferior in the engorged scrotum and was
difficult to palpate.

A 6-year-old girl (A) and an 11-year-old boy (B) each presented
for evaluation of an erythematous, pruritic, papular
rash that developed after swimming in a Wisconsin lake.
Each child was otherwise completely healthy.

Four hours before he arrived at the emergency department, a 33-year-old man had been struck in the face by a rock. A laceration and periorbital hematoma were noted on the left side of the patient’s face. He complained of pain in this area. There was no history of intraocular disease. The left globe was intact, and no neurologic deficit was found.

Despite the many
trials that
have demonstrated
the efficacy of statins in
reducing the risk of cardiovascular
events, a large
number of patients who are
treated with these drugs
still experience such
events. This may be because
patients who require
intensive lipid lowering are
not receiving adequate
dosages of statins.

A 43-year-old woman presented to the emergency department with a 4-day history of worsening erythema, swelling, and pruritus that developed on the face and progressed to the abdomen, back, and lower legs. In the past 2 to 3 days, fluid-filled blisters had arisen, followed by skin sloughing; the patient also reported subjective fevers. Another physician had prescribed naproxen for back pain 6 days earlier. The patient had a history of asthma, with rare inhaler use, and depression, for which she had taken citalopram for 2 years.

A54-year-old white woman presents
with extremely tender,
firm lesions on the right hip and legs
that have been increasing in size and
number over the past few months.


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