Aortic Insufficiency

ID CC A 24-year-old man complains of easy fatigability, dyspnea on mild exertion, and angina. HPI He also admits to having occasional spells of lightheadedness and fainting while playing basketball. PE Crescendo-decrescendo systolic ejection murmur to right of sternum and radiating to neck soft S2 with paradoxical splitting (due to aortic valve closure preceding pulmonary valve closure) weak and delayed carotid pulses. Labs ECG left ventricular hypertrophy. imaging CXR calcifications on valve...

Pe

A 54-year-old white male complains of easy fatigability, shortness of breath, headache, and lightheadedness over the course of almost one year, with increasing severity. He has also noticed a feeling of heaviness in his abdomen and increasing girth as well as recurrent deep pain in the legs and occasionally in the upper abdomen. Massive splenomegaly enlarged liver moderate amount of ascitic fluid multiple petechiae on thorax and extremities no lymphadenopathy one differential feature shared...

Osteogenic Sarcoma

ID CC A 62-year-old Jewish male visits his family doctor because of epistaxis, headache, and dizziness. HPI The patient had black, tarry stools MELENA two months ago and was previously admitted to the hospital for deep venous thrombosis. He also describes episodes of severe generalized itching PRURITUS , primarily after showering. PE VS hypertension BP 170 100 . PE obese and plethoric mild cyanosis engorged, tortuous retinal veins with dark red hue on funduscopy palpable spleen. Labs CBC...