Thoracic Key

GASTROINTESTINAL BLEEDING, UPPER   33A A 74-year-old man with severe osteoarthritis presents to the emergency department reporting two episodes of melena (black stools) without hematochezia (bright red blood in the stools) or…

KNEE PAIN   44A A 41-year-old man presents to urgent care clinic complaining of right medial knee pain. His pain began after he twisted his knee playing soccer 1 month ago. At…

SUBSTANCE ABUSE   64A A 32-year-old unemployed man presents to the emergency department with right lower quadrant (RLQ) abdominal pain of 17 hours’ duration. He has a fever of 38.9°C, rebound tenderness…

OSTEOPOROSIS   75A A 72-year-old woman presents to the emergency department after falling in her home. She slipped on spilled water in her kitchen. She was unable to get up after her…

HYPERTHYROIDISM   72A A 25-year-old African American woman presents with a complaint of rapid weight loss despite a voracious appetite. Physical examination reveals tachycardia (pulse rate, 110 beats/min at rest), fine moist…

PSORIASIS   3A A 25-year-old woman presents with a complaint of rash that has developed over the past several weeks and seems to be progressing. She describes the involved areas as mildly…

VITAMIN B12 DEFICIENCY ANEMIA   26A A 58-year-old woman presents to the emergency department with complaints of progressive fatigue and weakness for the past 6 months. She is short of breath after…

ASTHMA   4A A 25-year-old previously well woman presents to your office with complaints of episodic shortness of breath and chest tightness. She has had these symptoms on and off for about…

PULMONARY EMBOLISM   11A A 57-year-old man has a right total knee replacement for severe degenerative joint disease. Four days later, he develops shortness of breath and right-sided pleuritic chest pain. He…

ACUTE MYOCARDIAL INFARCTION   13A A 71-year-old man presents to the emergency department with a sudden onset of substernal chest pain 1 hour ago. He describes the pain as a heavy pressure…