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What's Your Diagnosis

What's Your Diagnosis?

To what diagnosis do the clinical findings and images in each of these cases point?

What's Your Diagnosis

The patient has had 10 episodes of bleeding in the past 24 hours. Can you find clues to the underlying problem in the history and on the CT scan?

A 64-year-old man presents to the emergency department with a history of 10 episodes of rectal bleeding and diffuse intermittent abdominal pain over the past 24 hours.

This highly pruritic rash has been present for about 2 weeks. The teen says he believes it is spreading. What's your diagnosis?

Two hours earlier the patient had vomited to dislodge food stuck in his throat. This had been effective in the past but had never produced blood. Chest and epigastric pain worsened when he lay down.

A 48-year-old man presents to the emergency department with chest pain and hematemesis. History is significant for hiatal hernia, acid reflux, and a single esophageal dilatation 15 years ago for an impacted food bolus.

A 35-year-old woman, in the ED for the second time in the same day, is described by ambulance medics as "bizarre." ECG and labs are normal except for elevated urinary and peripheral WBC counts. More, here.

Bacterial meningitis presents with the triad of headache, fever, altered mental status. Stiff neck, vomiting, and photophobia may also be present.

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