Archives for 2013

Patient has this new skin finding, what should you worry about?

This is an actual cause of a patient who presented to Stanford Hospital and was diagnosed with pneumonia. He had this skin finding present throughout both of his legs. What should you be worried about? This patient has livedo reticularis. This can be a sign of severe bacteremia and possible sepsis. This patient was later

Stanford 25: Approach to Tremor

Using a Google Glass, we filmed a patient with tremor who was admitted to Stanford Hospital. In this video, we aim to provide you an overview of the approach your patient with tremor. *|YOUTUBE:myQdK6BuBws|*

Congratulations to our ACP Winners!

Every year the Society for the American College of Physicians (ACP) holds an annual regional conference for internal medicine physicians and residents. The meeting also consists of three contests: a medical jeopardy competition and two poster competitions: a clinical vignette category and research & quality improvement category. This past weekend our Stanford residents took first

Happy Halloween! So this is the scariest picture we’ve got! What is it?

Okay so it wasn’t that scary… It’s just a solitary keratoacanthoma (KA). A keratoacanthoma represents a proliferation of the squamous layer of the skin. Some doctors believe this to represent a spectrum of squamous carcinoma of the skin. Sun exposure is a risk factor. All patients with the lesion should get a dermatology referral and

An interesting illustration of the physical exam

An article was recently published in the Annals of Internal Medicine using a cartoon to illustrate a doctor’s haunting history of misdiagnosis in a patient with respiratory distress. The article highlights the cause of this misdiagnosis from missing the physical exam finding. We can’t provide the full article but here’s a link to the Annals.

If you put your stethoscope over this, what will you hear?

Okay, so if we simply ask you what this is you’ll say a thyroid goiter. We knew you’re too smart for that! But how about if you listen over the mass? What might you hear and in what disease (or diseases) might you hear it? You may hear a thyroid bruit. A thyroid bruit is

A patient presents with foot pain and these chronic findings?

A patient comes to you with these findings and new onset of left foot pain. What’s your likely diagnosis? This is a patient with chronic tophaceous gout likely presenting with an acute gout attack of the foot. The enlarged and often inflamed fingers (dactylitis) can be mistaken for psoriatic arthritis and ankylosing spondylitis. Additionally, the

Stanford ENT Free Oral Screening November 2nd

Please read below and support our ENT colleagues as they about to have their second annual Stanford Free Oral Screening event! Oral cancer affects 40,000 new people each year and kills one life every hour in the United States. Many cases are preventable and can be linked to tobacco use, alcohol, HPV, and lack of

Your patient gets this rash, what’s the diagnosis?

Two weeks after being started on carbamazepine, the patient develops this rash associated with itching and facial swelling. What’s the diagnosis? (Hint: look at the complete blood count differential) This patient has drug reaction with eosinophilia and systemic symptoms (DRESS). DRESS is an immune response seen most commonly with certain drugs including anticonvulsants (lamotrigine, carbamazepine

This patient presents with chest pain. What’s the diagnosis?

This 32 yr old patient presents with chest pain. Based on the pictures, can you diagnose what the most likely cause is? The cause of chest pain is Aortic dissection. This is a patient with Marfan’s Syndrome. A majority of adults with Marfan’s syndrome have aortic dilation and if untreated can lead to aortic dissection.