Medical Knowledge

Coin-Shaped Opacities in the Stomach

On day 7 after hospital admission, a patient with end-stage kidney disease prescribed sevelamer, hydrocodone-acetaminophen, hydromorphone, and chewable lanthanum tablets developed intermittent apneic episodes, bilateral rhonchi, and responsiveness to verbal commands only with deep painful stimulus; a chest radiograph showed…

Longitudinal Follow-Up of Participants With Tobacco Exposure and Preserved Spirometry

Importance  People who smoked cigarettes may experience respiratory symptoms without spirometric airflow obstruction. These individuals are typically excluded from chronic obstructive pulmonary disease (COPD) trials and lack evidence-based therapies. Objective  To define the natural history of persons with tobacco exposure and preserved…

A Child With Large Pulmonary and Liver Cysts

A previously healthy 7-year-old had 1 week of fevers, productive cough, and lethargy, which did not improve after 3 days of oral cefuroxime. He lived in a rural area and had close contact with dogs, cattle, and sheep. White blood…

Skin Lesions, Foot Drop, and Hand Contractures

A previously healthy individual in his 20s had 3 months of annular skin lesions, with numbness and paresthesia in the affected areas. Physical examination revealed multiple tattoos, bilateral palpable thickened auricular and ulnar nerves, and claw-hand deformity; test results for…

Heart Failure, Neuropathy, and Spinal Stenosis

A 60-year-old patient with a history of lumbar spinal stenosis had 2 months of chest pain and shortness of breath with exertion and 3 months of toe numbness. Laboratory testing showed elevated levels of high-sensitivity troponin, brain-type natriuretic peptide, aspartate…