Stephen Schabel, MD

December 31, 2006

A 62-year-old man has had nightsweats and worsening fever andcough for the last 4 days; 2 days agohe had an episode of hemoptysis. Hedenies trauma or travel to a foreigncountry but has a 30-pack-year smokinghistory. The medical history isotherwise noncontributory.

December 31, 2006

A 53-year-old man complains ofdyspnea and a cough that has progressivelyworsened over the pastweek. He denies recent trauma.

December 31, 2006

A 29-year-old woman is brought to the emergency department after a caraccident. She complains of head pain and has a contusion over the posterioraspect of the right temporal bone and right occipital bone; a small amount ofblood flows from the right external auditory canal. She has only a vague recollectionof the accident. Past medical history-although difficult to ascertain-seems noncontributory.

December 31, 2006

A 58-year-old man complains ofintermittent headaches that beganabout 2 months earlier and have recentlyincreased in severity. Theheadaches occur at various times ofthe day and improve slightly whenhe sits. He denies trauma, fever, photophobia,and other neurologicsymptoms. He has 1 alcoholic drinka day and has smoked 1 pack of cigarettesa day for the past 20 years.Medical history is noncontributory.

December 31, 2006

A 64-year-old woman presentsto the emergency department withworsening crampy abdominal painthat began the night before. Afterthe pain started, she had a bowelmovement containing a significantamount of blood; since then she hashad episodes of diarrhea. She hadbeen previously healthy, denies traumaand fever, and knows no one withsimilar symptoms. She reports norecent enema, endoscopy, or otherabdominal procedure.

December 31, 2006

A 25-year-old man complainsof right hip pain that began earlierin the day when he fell and landedon his hip while playing basketball.He has no other symptoms, and hishistory is noncontributory.

December 31, 2006

A 56-year-old woman complainsof right hip pain that has been presentfor several weeks but has recentlyworsened. She denies recent trauma,fever, and increased physicalactivity. She has no history of arthritis,but she does have systemiclupus erythematosus, which a dailyregimen of prednisone, 20 mg PO,has kept in remission. Her medicalhistory is otherwise unremarkable.

December 31, 2006

A 13-year-old boy complains ofpain in his right hip. The pain began3 days earlier after he was tackledseveral times while playing footballwith his friends. He was able to walkhome. The pain has increased sincethat time. Although the patient is stillable to walk, he now has a limp andfavors his left leg. The patient isotherwise healthy and has no significantmedical history.

December 31, 2006

A 67-year-old woman who is being treated as an inpatient for head traumacomplains of vague tenderness during an abdominal examination. Othercomplaints are difficult to assess. She had been placed on an oxygen ventilator;however, her cognitive function and pulmonary function are improving, andher cerebral edema is diminished.

May 01, 2006

A 57-year-old woman presents with severe chest pain, and a frontal upright radiograph of the chest is obtained. What does this image reveal, and how will you arrive at a diagnosis?