Thoracic Key

SYSTEMIC LUPUS ERYTHEMATOSUS   46A A 22-year-old African American woman reports intermittent joint pain in her right knee and the joints of the fingers of her right hand, especially the proximal interphalangeal…

DEPRESSION   57A A 57-year-old woman presents to her primary care clinician complaining of insomnia for 4 months. She reports that she can often fall asleep but awakens very early in the…

SHOCK   22A A young woman is brought to the emergency department by ambulance after a severe motor vehicle accident. She is unconscious. Her blood pressure is 64/40 mm Hg and heart…

GASTROINTESTINAL BLEEDING, LOWER   32A A 53-year-old man comes to the emergency department with a 3-hour history of bright red blood per rectum. The man states that he had been feeling well…

HYPERPARATHYROIDISM, PRIMARY   71A A 56-year-old woman presents to her primary care clinician complaining of progressive fatigue, weakness, and diffuse bony pain. She says that her symptoms have been getting worse over…

HYPOTHYROIDISM   73A A 55-year-old woman complains of fatigue, 30 lb of weight gain despite dieting, constipation, thinning hair, and menorrhagia. On physical examination, the thyroid gland is not palpable; the skin…

STROKE   62A An 82-year-old woman with atrial fibrillation comes to the emergency department with 1 hour of difficulty moving her right arm and leg. Her medical history includes a transient ischemic…

PARKINSON DISEASE   61A A 63-year-old man comes to the clinic with a several month history of difficulty with his gait and coordination. He finds walking difficult and has almost fallen on…

DIABETES MELLITUS, TYPE 1   67A A 22-year-old woman with a history of poorly controlled type 1 diabetes mellitus presents to the emergency department with abdominal pain, nausea, and vomiting. She had…

CIRRHOSIS   28A A 63-year-old man with a long history of alcohol use presents with a 6-month history of increasing abdominal girth, easy bruisability and worsening fatigue. He denies any history of…