Author | Ronald N. Rubin, MD

Articles

Middle-Aged Man With Severe Upper Back and Neck Pain

April 06, 2011

For 4 weeks, a 49-year-old man has had progressively worsening pain between his scapulae and in the lower part of his neck. The pain is now severe, and he takes high doses of acetaminophen and NSAIDs for relief.

Middle-Aged Man With an Incidental ECG Abnormality

March 12, 2011

A 44-year-old man presents for a preemployment physical examination. He is healthy, and he currently takes no long-term medications. A detailed review of systems reveals no ischemic chest pain, dyspnea with exertion, orthopnea, or any other symptoms of either coronary artery disease (CAD) or heart failure.

Alcoholic Man With Melena and Hematemesis

January 12, 2011

During the past 24 hours, a 56-year-old man has experienced melena and 2 episodes of hematemesis. He has biopsy-proven cirrhosis that resulted from heavy, prolonged alcohol consumption; however, he no longer drinks. Previous endoscopy revealed esophageal varices.

Screening for Vascular Disease in a Former Smoker

May 01, 2008

As part of his preparation for retirement, a 66-year-old executive undergoes a complete physical examination. He is in good health and has no symptoms to report. Along with other age-appropriate screening studies, you discuss testing for vascular disease with him.

Sudden Deterioration Following Acute Myocardial Infarction

April 16, 2008

Two days before a 72-year-old woman is admitted to the cardiac care unit (CCU), she had substernal discomfort she described as "heartburn," accompanied by episodes of nausea and vomiting. She attributed her symptoms to GI upset.

A Middle-Aged Woman With MI, Stroke, and DVT

February 01, 2008

A 57-year-old woman presents for follow-up several months after a series of thrombotic episodes. Four days after she underwent ankle fusion to relieve pain and edema associated with a leg fracture that had occurred 40 years earlier, she sustained a massive myocardial infarction (MI).

Leg Pain in a 62-Year-Old Man

January 01, 2008

A 62-year-old man presents with painful cramps in his left lower leg that began about 6 months earlier and have recently become more frequent. The cramps occur with vigorous walking and cease when he stops for several minutes.

Worsening Abdominal Pain in Man With History of Alcohol Abuse

October 01, 2007

Forty-eight hours ago, a 39-year-old man presented to the emergency department with emesis and severe upper abdominal pain of semi-acute onset, which radiated slightly to the back.

New Lymphadenopathy in a Woman With a History of Colon Cancer

September 01, 2007

A 47-year-old woman who recently completed adjuvant chemotherapy for colon cancer has painless cervical lymphadenopathy of 1 to 2 cm. She has no fever, sore throat, cough, or unexplained weight loss, and she denies exposure to ill persons or animals.

Elderly Man With Pain in His Thigh

August 01, 2007

A 77-year-old man complains of deep, aching pain of several months' duration in his left thigh that is exacerbated by both standing and walking.