Hyponatremia
HYPONATREMIA 49A A 75-year-old man with small cell carcinoma of the lung presents to the emergency department with altered mental status. The patient’s wife states that over the past few days,…
Altered Mental Status
ALTERED MENTAL STATUS 55A An 82-year-old woman with mild dementia is hospitalized in the intensive care unit (ICU) for urosepsis and treated with intravenous antibiotics. On hospital day 3, despite improvement…
Hypercalcemia
HYPERCALCEMIA 70A A 71-year-old woman with lung cancer presents to her primary care provider with complaints of constipation, nausea, and increased urination. She also has new depression and generalized weakness. Her…
Health Care–Associated Infections
HEALTH CARE–ASSOCIATED INFECTIONS 78A A 71-year-old man is admitted to the intensive care unit for pneumonia, sepsis, and acute respiratory distress syndrome. He is treated with intravenous (IV) ceftriaxone. An initial…
Cushing Syndrome
CUSHING SYNDROME 66A A 35-year-old woman has hypertension of recent onset. Review of systems reveals several months of weight gain and menstrual irregularity. On examination, she is obese, with a plethoric…
Smoking Cessation
SMOKING CESSATION 63A A 33-year-old man visits his primary care clinician for advice about how to quit cigarette smoking. He started smoking a half pack daily at age 16 years but…
Glomerulonephritis
GLOMERULONEPHRITIS 47A A 61-year-old woman presents to the emergency department with 3 days of shortness of breath and lower extremity swelling. She has been previously healthy with no history of heart…
Hyperaldosteronism
HYPERALDOSTERONISM 69A A 42-year-old man presents for evaluation of newly diagnosed hypertension. He is currently taking no medications and offers no complaints. A careful review of systems reveals symptoms of fatigue;…
Chronic Obstructive Pulmonary Disease
CHRONIC OBSTRUCTIVE PULMONARY DISEASE 5A A 72-year-old man with chronic obstructive pulmonary disease (COPD) presents to the emergency department with progressively worsening shortness of breath. Using 2 L/min of oxygen at…
Hypokalemia
HYPOKALEMIA 48A A 45-year-old woman presents to the emergency department after 5 days of nausea, vomiting, and diarrhea. She states that she has only been able to drink water occasionally, and…
