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A 62 year old man presents with a swollen right calf 3 weeks after undergoing a total left hip replacement. He is known to have rheumatoid arthritis. An Emergency Department doctor tells you that he feels the patient can be discharged. He tells you this because he shows you the D-Dimer result, which is “negative”. [...]
Let’s test your endocrinology knowledge with this teaser. As ever, leave your answer as a comment. Answer will be given in a few days. Which of these symptoms of hypoadrenalism will distinguish between primary adrenal failure and secondary (pituitary) adrenal insufficiency? a. Postural Hypotension b. Weight Loss c. Fatigue d. Hypoglycaemia e. Skin Pigmentation
The answer is…. b. Rheumatoid arthritis Symmetrical disease? Erosions? This is classical of RA X-ray changes that include 1. Erosions 2. Reduced joint space 3. Peri-articular osteoporosis 4. Nodules So from the initial history of disease [small joints, both hands], the likely diagnoses would be RA PsA (less likely) gout. Erosive changes are not specific [...]
EMQ’s EMQ’s are being increasingly used in research and papers have recently been published on their success in the USMLE. Its likely that many medical schools will adopt this N from many approach. An EMQ is simple: its a series of typically 6-10 answers, used a number of times with different question stems.They first cropped [...]
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