Author | Navin M. Amin, MD

Articles

Sudden Loss of Consciousness in an Elderly Woman

October 01, 2007

A comatose 82-year-old woman is brought to the emergency department. Her husband reports that after dinner she began to have difficulty in speaking, lost consciousness, and fell to the floor. He tried to rouse her, but was unsuccessful and called for an ambulance.

Young Child With Hematuria and Dysuria

March 01, 2007

A 3-year-old girl is brought to the office because of a1-week history of hematuria and dysuria. Her motherhad noticed bright red blood in the child’s urine anddiaper. The child did not have dysuria initially but latercomplained of a burning sensation.

Cough, Chest Pain, and Dyspnea in a Woman With Rheumatoid Arthritis

January 01, 2007

A 40-year-old Hispanic homemaker is admitted with a 3-week history of high fever, chest pain, and a dry, irritating cough. Her illness began insidiously with increasing right upper chest pain that is sharp, pleuritic, and rates a 6 on a pain scale of 1 to 10. The pain is associated with temperatures of up to 38.8°C (102°F) and chills, rigors, and profuse sweating that increase in the evening. Worsening dyspnea has been accompanied by a drop in effort tolerance.

Diagnostic Images, Treatment Decisions

December 31, 2006

A4-year-old boy has a 4-day historyof fever; a persistent dry,irritating cough; coryza; and anonpruritic rash. The rash startedaround the ears and then spread overthe trunk and limbs.

Woman With Facial Swelling and Dyspnea

December 31, 2006

A 59-year-old woman presents with generalized facialswelling and dyspnea that has progressed graduallyover the past month. The patient also reports a sensationof pressure in her neck and ears and swelling of the lowereyelids, neck, upper chest, and upper limbs. The bloodvessels on her upper chest are prominent. A dry, irritatingcough has worsened.

Girl With Severe Sore Throat and Dyspnea

December 31, 2006

A 12-year-old black girl is hospitalized because of increasinglysevere dyspnea and sore throat. The sorethroat started about a week earlier and was accompaniedby fever and chills. The patient was evaluated at an urgentcare center when her symptoms worsened, where she wasgiven ampicillin for a presumptive “strep throat.” A generalizedmaculopapular erythematous rash developed within24 hours of the start of therapy, and the ampicillin waspromptly withdrawn. The rash cleared gradually thereafter.Now the patient’s sore throat has worsened to the pointthat she has difficulty with drinking and eating. She hasbecome increasingly dyspneic during the past 24 hours.

Hepatomegaly in a Middle-Aged Woman

September 01, 2006

Hepatomegaly is detected during the routine physical examination of a healthy 40-year-old woman who is employed as a secretary. She has noticed some fullness in the right upper abdomen for many years, but it has not been accompanied by pain or GI symptoms.

Middle-Aged Woman With Asymptomatic Hepatomegaly

September 01, 2006

Hepatomegaly is detected during the routine physical examination of a healthy 40-year-old woman. She has noticed some fullness in the right upper abdomen for many years, but it has not been accompanied by pain or GI symptoms.

Man With Worsening Cough and Dyspnea

June 01, 2006

Man With Worsening Cough and Dyspnea

Young Man With Painless Penile Ulcer

May 01, 2006

Young Man With Painless Penile Ulcer