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FOR PRACTICING PHYSICIANS β€’ LONG-FORM CLINICAL REASONING

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200 complex clinical mysteries built around diagnostic pivots, treatment failure, misleading first impressions and the clue that changes the case. The diagnosis is never placed in the title or preview.

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FREE SAMPLE Cases 1–5 are completely open to everyone. πŸ”’ MEMBERS Cases 6–200 require Members Access. Login / Register
CASE 001 β€’ OPD

The Blood Pressure That Would Not Behave

The working diagnosis was resistant essential hypertension. Then a clue forced a diagnostic reset.

Cardiology / Endocrine
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CASE 002 β€’ Emergency

The Inferior MI That Needed More Than a Stent

The working diagnosis was uncomplicated inferior STEMI. Then a clue forced a diagnostic reset.

Cardiology
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CASE 003 β€’ Emergency

The Chest Pain With Two Pulses

The working diagnosis was acute coronary syndrome. Then a clue forced a diagnostic reset.

Cardiology
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CASE 004 β€’ Ward

The Troponin That Lied About the Coronaries

The working diagnosis was NSTEMI. Then a clue forced a diagnostic reset.

Cardiology
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CASE 005 β€’ OPD

The Heart Failure With a Normal Ejection Fraction

The working diagnosis was hypertensive HFpEF. Then a clue forced a diagnostic reset.

Cardiology
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CASE 006 β€’ Ward

The Breathlessness That Improved When She Sat Forward

The working diagnosis was refractory right-sided heart failure. Then a clue forced a diagnostic reset.

Cardiology
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CASE 007 β€’ Ward

The Fever That Was Hiding in the Murmur

The working diagnosis was prolonged viral fever. Then a clue forced a diagnostic reset.

Cardiology / Infectious Disease
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CASE 008 β€’ Emergency

The ECG That Changed After the Argument

The working diagnosis was anterior STEMI. Then a clue forced a diagnostic reset.

Cardiology
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CASE 009 β€’ OPD

The Athlete Who Fainted at the Finish Line

The working diagnosis was vasovagal syncope. Then a clue forced a diagnostic reset.

Cardiology
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CASE 010 β€’ Emergency

The Fever That Triggered a Dangerous Pattern

The working diagnosis was simple febrile illness. Then a clue forced a diagnostic reset.

Cardiology
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CASE 011 β€’ OPD

The Asthma That Was Really a Fungal Conversation

The working diagnosis was poorly controlled asthma. Then a clue forced a diagnostic reset.

Pulmonology
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CASE 012 β€’ Ward

The Pneumonia That Refused Every Antibiotic

The working diagnosis was nonresolving bacterial pneumonia. Then a clue forced a diagnostic reset.

Pulmonology
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CASE 013 β€’ OPD

The Farmer Whose Lungs Remembered the Harvest

The working diagnosis was recurrent atypical pneumonia. Then a clue forced a diagnostic reset.

Pulmonology
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CASE 014 β€’ ICU

The Hemoglobin That Fell While the Lungs Filled

The working diagnosis was ARDS from sepsis. Then a clue forced a diagnostic reset.

Pulmonology / Rheumatology
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CASE 015 β€’ OPD

The Young Man With Repeated Collapsed Lungs

The working diagnosis was primary spontaneous pneumothorax. Then a clue forced a diagnostic reset.

Pulmonology
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CASE 016 β€’ Emergency

The Breathless Patient With a Clear Chest X-ray

The working diagnosis was anxiety or viral dyspnea. Then a clue forced a diagnostic reset.

Pulmonology / Vascular
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CASE 017 β€’ Ward

The Milky CT That Was Not Edema

The working diagnosis was cardiogenic pulmonary edema. Then a clue forced a diagnostic reset.

Pulmonology
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CASE 018 β€’ Ward

The Steroid-Responsive Shadow With Eosinophils

The working diagnosis was community-acquired pneumonia. Then a clue forced a diagnostic reset.

Pulmonology
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CASE 019 β€’ Ward

The Cough That Came From the Bathroom

The working diagnosis was ordinary CAP. Then a clue forced a diagnostic reset.

Pulmonology / Infectious Disease
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CASE 020 β€’ OPD

The Weight Loss Hidden Behind a Negative Sputum Test

The working diagnosis was recurrent bacterial pneumonia. Then a clue forced a diagnostic reset.

Pulmonology / Infectious Disease
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CASE 021 β€’ OPD

The Pain That Arrived Twenty Minutes After Dinner

The working diagnosis was acid peptic disease. Then a clue forced a diagnostic reset.

Gastroenterology / Vascular
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CASE 022 β€’ Ward

The Liver Disease With a Vein Problem

The working diagnosis was decompensated cirrhosis. Then a clue forced a diagnostic reset.

Gastroenterology / Hepatology
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CASE 023 β€’ Emergency

The Psychiatric Patient With Abdominal Pain

The working diagnosis was functional abdominal pain. Then a clue forced a diagnostic reset.

Gastroenterology / Metabolic
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CASE 024 β€’ Ward

The Jaundice in a Young Man With Tremor

The working diagnosis was viral hepatitis. Then a clue forced a diagnostic reset.

Hepatology / Neurology
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CASE 025 β€’ OPD

The Diarrhea That Was Stealing Iron

The working diagnosis was refractory iron deficiency from diet. Then a clue forced a diagnostic reset.

Gastroenterology
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CASE 026 β€’ OPD

The Dark Skin, Diabetes and the Liver

The working diagnosis was metabolic fatty liver disease. Then a clue forced a diagnostic reset.

Hepatology / Endocrine
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CASE 027 β€’ Ward

The Fever, Joint Pain and Weight Loss No One Connected

The working diagnosis was seronegative inflammatory arthritis. Then a clue forced a diagnostic reset.

Gastroenterology / Infectious Disease
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CASE 028 β€’ OPD

The Ulcer That Was Not Acid

The working diagnosis was refractory peptic ulcer disease. Then a clue forced a diagnostic reset.

Gastroenterology / Endocrine
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CASE 029 β€’ Emergency

The Pancreatitis With a Normal Gallbladder

The working diagnosis was idiopathic acute pancreatitis. Then a clue forced a diagnostic reset.

Gastroenterology
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CASE 030 β€’ Ward

The Ascites With a Heartbeat

The working diagnosis was portal hypertensive cirrhosis. Then a clue forced a diagnostic reset.

Gastroenterology / Cardiology
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CASE 031 β€’ Emergency

The Headache That Worsened After Delivery

The working diagnosis was postpartum migraine. Then a clue forced a diagnostic reset.

Neurology / Obstetric Medicine
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CASE 032 β€’ ICU

The Psychosis That Became a Seizure Disorder

The working diagnosis was primary psychiatric illness. Then a clue forced a diagnostic reset.

Neurology / Immunology
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CASE 033 β€’ Ward

The Weakness That Climbed After a Diarrheal Illness

The working diagnosis was viral myalgia. Then a clue forced a diagnostic reset.

Neurology
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CASE 034 β€’ OPD

The Double Vision That Improved After Sleep

The working diagnosis was cranial nerve palsy. Then a clue forced a diagnostic reset.

Neurology
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CASE 035 β€’ Emergency

The Alcohol Withdrawal That Was Not Withdrawal

The working diagnosis was alcohol withdrawal delirium. Then a clue forced a diagnostic reset.

Neurology / Nutrition
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CASE 036 β€’ Emergency

The Stroke With a Thunderclap Beginning

The working diagnosis was migraine. Then a clue forced a diagnostic reset.

Neurology
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CASE 037 β€’ ICU

The Hypertension That Blurred Her Vision

The working diagnosis was ischemic stroke. Then a clue forced a diagnostic reset.

Neurology / Hypertension
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CASE 038 β€’ Emergency

The Back Pain That Became Weak Legs Overnight

The working diagnosis was mechanical low back pain. Then a clue forced a diagnostic reset.

Neurology / Infectious Disease
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CASE 039 β€’ Ward

The Confusion That Appeared After Sodium Improved

The working diagnosis was persistent hepatic encephalopathy. Then a clue forced a diagnostic reset.

Neurology / Electrolytes
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CASE 040 β€’ OPD

The Gait, Memory and Bladder Triad That Looked Like Aging

The working diagnosis was degenerative dementia. Then a clue forced a diagnostic reset.

Neurology
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CASE 041 β€’ Ward

The Creatinine Rise After the New Prescription

The working diagnosis was dehydration-related AKI. Then a clue forced a diagnostic reset.

Nephrology
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CASE 042 β€’ OPD

The Hematuria That Followed a Sore Throat Too Quickly

The working diagnosis was post-streptococcal glomerulonephritis. Then a clue forced a diagnostic reset.

Nephrology
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CASE 043 β€’ OPD

The Kidney Failure With Hearing Loss

The working diagnosis was recurrent nonspecific hematuria. Then a clue forced a diagnostic reset.

Nephrology / Genetic
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CASE 044 β€’ Ward

The Potassium That Stayed Low Despite Replacement

The working diagnosis was poor dietary potassium intake. Then a clue forced a diagnostic reset.

Nephrology / Endocrine
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CASE 045 β€’ Ward

The Edema With a Blood Clot

The working diagnosis was simple dependent edema. Then a clue forced a diagnostic reset.

Nephrology
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CASE 046 β€’ ICU

The AKI With Platelets Falling

The working diagnosis was septic AKI with DIC. Then a clue forced a diagnostic reset.

Nephrology / Hematology
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CASE 047 β€’ OPD

The Recurrent Stones With a High Calcium

The working diagnosis was diet-related nephrolithiasis. Then a clue forced a diagnostic reset.

Nephrology / Endocrine
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CASE 048 β€’ Ward

The Swelling That Appeared After a Skin Infection

The working diagnosis was cellulitis-associated fluid retention. Then a clue forced a diagnostic reset.

Nephrology
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CASE 049 β€’ Ward

The Sodium That Fell With a Small Lung Mass

The working diagnosis was diuretic-associated hyponatremia. Then a clue forced a diagnostic reset.

Nephrology / Oncology
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CASE 050 β€’ OPD

The Hypertension With a Whooshing Abdomen

The working diagnosis was essential hypertension. Then a clue forced a diagnostic reset.

Nephrology / Vascular
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CASE 051 β€’ Ward

The Patient Who Needed Steroids Before Thyroxine

The working diagnosis was isolated primary hypothyroidism. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 052 β€’ ICU

The Fever With a Heart Rate of 160

The working diagnosis was sepsis. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 053 β€’ ICU

The Hypothermic Patient With Normal-Looking Labs

The working diagnosis was sepsis with hypothermia. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 054 β€’ OPD

The Sweating Spells That Disappeared After Eating

The working diagnosis was panic attacks. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 055 β€’ OPD

The Resistant Hypertension With a Quiet Potassium

The working diagnosis was essential hypertension. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 056 β€’ Emergency

The Constipation, Confusion and Calcium

The working diagnosis was dehydration. Then a clue forced a diagnostic reset.

Endocrinology / Oncology
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CASE 057 β€’ OPD

The Enlarging Shoes That Predated the Diabetes

The working diagnosis was type 2 diabetes with obesity. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 058 β€’ OPD

The Bruises That Came With New Diabetes

The working diagnosis was metabolic syndrome. Then a clue forced a diagnostic reset.

Endocrinology
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CASE 059 β€’ Ward

The Polyuria That Began After Neurosurgery

The working diagnosis was osmotic diuresis. Then a clue forced a diagnostic reset.

Endocrinology / Neuro
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CASE 060 β€’ Emergency

The DKA With a Nearly Normal Glucose

The working diagnosis was starvation ketosis. Then a clue forced a diagnostic reset.

Endocrinology / Critical Care
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CASE 061 β€’ ICU

The Fever That Ate the Blood Counts

The working diagnosis was sepsis. Then a clue forced a diagnostic reset.

Hematology / Immunology
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CASE 062 β€’ OPD

The Anemia With Dark Morning Urine

The working diagnosis was iron deficiency anemia. Then a clue forced a diagnostic reset.

Hematology
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CASE 063 β€’ ICU

The Platelets That Fell While the Brain Changed

The working diagnosis was ITP. Then a clue forced a diagnostic reset.

Hematology
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CASE 064 β€’ OPD

The Back Pain With an ESR of 110

The working diagnosis was mechanical back pain. Then a clue forced a diagnostic reset.

Hematology / Oncology
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CASE 065 β€’ Ward

The Infection That Unmasked a Fragile Red Cell

The working diagnosis was sepsis-related anemia. Then a clue forced a diagnostic reset.

Hematology
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CASE 066 β€’ OPD

The Macrocytosis With Numb Feet

The working diagnosis was folate deficiency. Then a clue forced a diagnostic reset.

Hematology / Nutrition
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CASE 067 β€’ Emergency

The Bruising Patient Whose Fibrinogen Was Disappearing

The working diagnosis was DIC from sepsis. Then a clue forced a diagnostic reset.

Hematology / Oncology
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CASE 068 β€’ OPD

The Lymph Nodes That Followed Night Sweats

The working diagnosis was recurrent infection. Then a clue forced a diagnostic reset.

Hematology / Oncology
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CASE 069 β€’ OPD

The Clotting Patient With Recurrent Miscarriages

The working diagnosis was unprovoked DVT only. Then a clue forced a diagnostic reset.

Hematology / Rheumatology
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CASE 070 β€’ OPD

The White Count That Kept Rising After Infection Resolved

The working diagnosis was reactive leukocytosis. Then a clue forced a diagnostic reset.

Hematology
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CASE 071 β€’ Ward

The Asthma Patient With Purple Spots and Numb Feet

The working diagnosis was asthma exacerbation. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 072 β€’ Ward

The Sinusitis That Reached the Kidneys

The working diagnosis was recurrent sinus infection. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 073 β€’ Emergency

The Headache That Threatened Vision

The working diagnosis was tension headache. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 074 β€’ Ward

The Fever of Unknown Origin With a Salmon Rash

The working diagnosis was occult infection. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 075 β€’ Ward

The Young Woman With Clots and Low Platelets

The working diagnosis was ITP. Then a clue forced a diagnostic reset.

Rheumatology / Hematology
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CASE 076 β€’ Ward

The Foot Drop That Followed Weight Loss

The working diagnosis was diabetic neuropathy. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 077 β€’ OPD

The Dry Eyes That Became a Kidney Problem

The working diagnosis was isolated hypokalemia. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 078 β€’ OPD

The Weakness With a Rash Over the Knuckles

The working diagnosis was drug-related myopathy. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 079 β€’ OPD

The Fingers That Changed Color Before the Lungs

The working diagnosis was primary Raynaud phenomenon. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 080 β€’ Ward

The Fever After Sun Exposure With Proteinuria

The working diagnosis was uncomplicated UTI. Then a clue forced a diagnostic reset.

Rheumatology
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CASE 081 β€’ Ward

The Fever With a Black Scab

The working diagnosis was dengue or viral fever. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 082 β€’ Ward

The Fever After Wading Through Floodwater

The working diagnosis was viral hepatitis. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 083 β€’ ICU

The Pneumonia With Abscesses in a Diabetic Farmer

The working diagnosis was routine bacterial pneumonia. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 084 β€’ Ward

The Fever That Returned Every Evening

The working diagnosis was malaria. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 085 β€’ OPD

The Night Sweats With Back Pain and Raw Milk

The working diagnosis was tuberculosis. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 086 β€’ Ward

The Confusion in a Patient With a Normal Neck

The working diagnosis was viral encephalitis. Then a clue forced a diagnostic reset.

Infectious Disease / Neurology
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CASE 087 β€’ Emergency

The Fever With Rigors After a Trip East

The working diagnosis was viral fever. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 088 β€’ ICU

The Fever That Lowered the Platelets Before the Pressure

The working diagnosis was simple dengue fever. Then a clue forced a diagnostic reset.

Infectious Disease
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CASE 089 β€’ ICU

The Sore Throat Followed by a Strange Rash and Shock

The working diagnosis was cellulitis with sepsis. Then a clue forced a diagnostic reset.

Infectious Disease / Critical Care
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CASE 090 β€’ ICU

The Fever With a New Heart Block

The working diagnosis was simple infective endocarditis. Then a clue forced a diagnostic reset.

Infectious Disease / Cardiology
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CASE 091 β€’ Emergency

The Agitated Patient With Clonus

The working diagnosis was sepsis or anxiety. Then a clue forced a diagnostic reset.

Toxicology / Pharmacology
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CASE 092 β€’ ICU

The Rigid Patient After an Antipsychotic Change

The working diagnosis was sepsis. Then a clue forced a diagnostic reset.

Toxicology / Pharmacology
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CASE 093 β€’ Emergency

The Tachypnea That Was Compensation, Not Anxiety

The working diagnosis was panic hyperventilation. Then a clue forced a diagnostic reset.

Toxicology
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CASE 094 β€’ ICU

The Lactic Acidosis With a Medication Clue

The working diagnosis was septic shock. Then a clue forced a diagnostic reset.

Toxicology / Endocrine
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CASE 095 β€’ Emergency

The Slow Pulse With Yellow Vision

The working diagnosis was sick sinus syndrome. Then a clue forced a diagnostic reset.

Toxicology / Cardiology
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CASE 096 β€’ ICU

The Shock With a Quiet Heart Rate

The working diagnosis was septic shock. Then a clue forced a diagnostic reset.

Toxicology / Cardiology
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CASE 097 β€’ Emergency

The Tremor That Became Ataxia After Dehydration

The working diagnosis was viral gastroenteritis. Then a clue forced a diagnostic reset.

Toxicology / Psychiatry
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CASE 098 β€’ ICU

The High Anion Gap With Calcium Crystals

The working diagnosis was alcoholic ketoacidosis. Then a clue forced a diagnostic reset.

Toxicology
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CASE 099 β€’ Emergency

The Headache Everyone in the House Shared

The working diagnosis was viral syndrome. Then a clue forced a diagnostic reset.

Toxicology
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CASE 100 β€’ OR / ICU

The Hyperthermia After Surgery

The working diagnosis was postoperative sepsis. Then a clue forced a diagnostic reset.

Toxicology / Anesthesia
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CASE 101 β€’ Ward

The Fever That Returned Every Evening

The working diagnosis was partially treated bacterial infection. Then one discordant clue forced the team to rebuild the case.

Infectious Disease
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CASE 102 β€’ Ward

The Pneumonia That Followed the Birds

The working diagnosis was community-acquired pneumonia. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Pulmonology
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CASE 103 β€’ Ward

The Fever With a New Heart Murmur

The working diagnosis was viral fever. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Cardiology
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CASE 104 β€’ Ward

The Back Pain After a Fever

The working diagnosis was mechanical low-back pain. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Neurology
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CASE 105 β€’ Ward

The Diarrhea After the Antibiotic

The working diagnosis was antibiotic-associated loose stools. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Gastroenterology
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CASE 106 β€’ Emergency

The Rash That Started at the Wrists

The working diagnosis was viral exanthem. Then one discordant clue forced the team to rebuild the case.

Infectious Disease
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CASE 107 β€’ Emergency

The Fever With a Falling Platelet Count

The working diagnosis was dengue fever. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Hematology
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CASE 108 β€’ OPD

The Cough With a Normal Chest X-ray

The working diagnosis was post-viral cough. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Pulmonology
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CASE 109 β€’ Emergency

The Confusion After a Dog Bite Months Ago

The working diagnosis was acute encephalitis. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Neurology
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CASE 110 β€’ ICU

The Fever After the Flood

The working diagnosis was viral fever. Then one discordant clue forced the team to rebuild the case.

Infectious Disease / Nephrology
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CASE 111 β€’ Emergency

The Breathlessness With a Quiet Chest

The working diagnosis was acute asthma. Then one discordant clue forced the team to rebuild the case.

Pulmonology
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CASE 112 β€’ Ward

The Asthma That Began After Fifty

The working diagnosis was late-onset asthma. Then one discordant clue forced the team to rebuild the case.

Pulmonology / Rheumatology
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CASE 113 β€’ OPD

The Recurrent Pneumonia in the Same Lobe

The working diagnosis was recurrent community-acquired pneumonia. Then one discordant clue forced the team to rebuild the case.

Pulmonology
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CASE 114 β€’ Emergency

The Dyspnea With a Normal Oxygen Saturation

The working diagnosis was anxiety. Then one discordant clue forced the team to rebuild the case.

Pulmonology / Hematology
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CASE 115 β€’ OPD

The Wheeze That Was Not Asthma

The working diagnosis was bronchial asthma. Then one discordant clue forced the team to rebuild the case.

Pulmonology / ENT
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CASE 116 β€’ Ward

The Lung Infiltrates That Kept Moving

The working diagnosis was recurrent pneumonia. Then one discordant clue forced the team to rebuild the case.

Pulmonology / Immunology
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CASE 117 β€’ OPD

The Smoker With Clubbing and Joint Pain

The working diagnosis was COPD. Then one discordant clue forced the team to rebuild the case.

Pulmonology / Rheumatology
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CASE 118 β€’ Emergency

The Breathlessness After Delivery

The working diagnosis was postpartum anxiety. Then one discordant clue forced the team to rebuild the case.

Pulmonology / Cardiology
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CASE 119 β€’ Ward

The Pleural Fluid That Looked Like Milk

The working diagnosis was empyema. Then one discordant clue forced the team to rebuild the case.

Pulmonology
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CASE 120 β€’ OPD

The Cough That Improved on Holidays

The working diagnosis was chronic bronchitis. Then one discordant clue forced the team to rebuild the case.

Pulmonology / Occupational Medicine
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CASE 121 β€’ OPD

The Syncope During Exercise

The working diagnosis was vasovagal syncope. Then one discordant clue forced the team to rebuild the case.

Cardiology
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CASE 122 β€’ Ward

The Heart Failure With Thick Walls

The working diagnosis was hypertensive heart disease. Then one discordant clue forced the team to rebuild the case.

Cardiology
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CASE 123 β€’ Emergency

The Palpitations After a Cold Medicine

The working diagnosis was panic attack. Then one discordant clue forced the team to rebuild the case.

Cardiology / Toxicology
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CASE 124 β€’ Emergency

The Chest Pain After an Emotional Shock

The working diagnosis was acute anterior MI. Then one discordant clue forced the team to rebuild the case.

Cardiology
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CASE 125 β€’ Ward

The Heart Block With a Skin Rash

The working diagnosis was degenerative conduction disease. Then one discordant clue forced the team to rebuild the case.

Cardiology / Infectious Disease
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CASE 126 β€’ Ward

The New Murmur After a Dental Procedure

The working diagnosis was innocent murmur. Then one discordant clue forced the team to rebuild the case.

Cardiology / Infectious Disease
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CASE 127 β€’ OPD

The Athlete With an Unexpected ECG

The working diagnosis was athlete's heart. Then one discordant clue forced the team to rebuild the case.

Cardiology
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CASE 128 β€’ Emergency

The Chest Pain That Improved Sitting Forward

The working diagnosis was acute coronary syndrome. Then one discordant clue forced the team to rebuild the case.

Cardiology
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CASE 129 β€’ OPD

The Hypertension With Weak Leg Pulses

The working diagnosis was essential hypertension. Then one discordant clue forced the team to rebuild the case.

Cardiology
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CASE 130 β€’ Emergency

The Collapse After Starting a New Antibiotic

The working diagnosis was septic shock. Then one discordant clue forced the team to rebuild the case.

Cardiology / Allergy
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CASE 131 β€’ Ward

The Headache With Low Sodium

The working diagnosis was dehydration. Then one discordant clue forced the team to rebuild the case.

Endocrinology / Nephrology
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CASE 132 β€’ OPD

The Diabetes That Suddenly Became Easy to Control

The working diagnosis was improved type 2 diabetes. Then one discordant clue forced the team to rebuild the case.

Endocrinology
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CASE 133 β€’ OPD

The Weight Gain With Purple Marks

The working diagnosis was metabolic syndrome. Then one discordant clue forced the team to rebuild the case.

Endocrinology
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CASE 134 β€’ OPD

The Tremor With Weight Loss and Eye Pain

The working diagnosis was anxiety disorder. Then one discordant clue forced the team to rebuild the case.

Endocrinology
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CASE 135 β€’ OPD

The Recurrent Stones With a High Calcium

The working diagnosis was dietary calcium excess. Then one discordant clue forced the team to rebuild the case.

Endocrinology / Nephrology
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CASE 136 β€’ OPD

The Hypertension With Low Potassium

The working diagnosis was essential hypertension. Then one discordant clue forced the team to rebuild the case.

Endocrinology / Cardiology
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CASE 137 β€’ Emergency

The Collapse After Steroids Were Stopped

The working diagnosis was sepsis. Then one discordant clue forced the team to rebuild the case.

Endocrinology
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CASE 138 β€’ Ward

The Thirst That Began After Head Injury

The working diagnosis was uncontrolled diabetes mellitus. Then one discordant clue forced the team to rebuild the case.

Endocrinology / Neurology
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CASE 139 β€’ OPD

The Enlarged Hands Nobody Noticed

The working diagnosis was normal aging. Then one discordant clue forced the team to rebuild the case.

Endocrinology
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CASE 140 β€’ Emergency

The Confusion With a Normal Glucose

The working diagnosis was stroke. Then one discordant clue forced the team to rebuild the case.

Endocrinology
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CASE 141 β€’ OPD

The Anemia That Did Not Respond to Iron

The working diagnosis was iron deficiency anemia. Then one discordant clue forced the team to rebuild the case.

Hematology / Gastroenterology
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CASE 142 β€’ Ward

The Bruising With a Normal Platelet Count

The working diagnosis was immune thrombocytopenia. Then one discordant clue forced the team to rebuild the case.

Hematology
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CASE 143 β€’ OPD

The Dark Urine Every Morning

The working diagnosis was hematuria. Then one discordant clue forced the team to rebuild the case.

Hematology
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CASE 144 β€’ Ward

The Anemia With Back Pain and Kidney Injury

The working diagnosis was anemia of CKD. Then one discordant clue forced the team to rebuild the case.

Hematology / Nephrology
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CASE 145 β€’ Emergency

The Fever After a Blood Transfusion

The working diagnosis was febrile non-hemolytic reaction. Then one discordant clue forced the team to rebuild the case.

Hematology
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CASE 146 β€’ Ward

The Platelets That Fell After Heparin

The working diagnosis was sepsis-associated thrombocytopenia. Then one discordant clue forced the team to rebuild the case.

Hematology
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CASE 147 β€’ Ward

The Stroke in a Young Woman With Miscarriages

The working diagnosis was cryptogenic stroke. Then one discordant clue forced the team to rebuild the case.

Hematology / Rheumatology
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CASE 148 β€’ OPD

The Macrocytosis With Tingling Feet

The working diagnosis was folate deficiency. Then one discordant clue forced the team to rebuild the case.

Hematology / Neurology
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CASE 149 β€’ Ward

The Pancytopenia With a Large Spleen

The working diagnosis was aplastic anemia. Then one discordant clue forced the team to rebuild the case.

Hematology
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CASE 150 β€’ Ward

The Clot That Appeared in the Abdomen

The working diagnosis was provoked venous thrombosis. Then one discordant clue forced the team to rebuild the case.

Hematology
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CASE 151 β€’ Emergency

The Abdominal Pain After Starting a New Drug

The working diagnosis was gastritis. Then one discordant clue forced the team to rebuild the case.

Gastroenterology
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CASE 152 β€’ OPD

The Diarrhea That Woke Him at Night

The working diagnosis was irritable bowel syndrome. Then one discordant clue forced the team to rebuild the case.

Gastroenterology
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CASE 153 β€’ Ward

The Constipation With a New Neurologic Sign

The working diagnosis was functional constipation. Then one discordant clue forced the team to rebuild the case.

Gastroenterology / Neurology
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CASE 154 β€’ Emergency

The Abdominal Pain With Normal Lipase

The working diagnosis was dyspepsia. Then one discordant clue forced the team to rebuild the case.

Gastroenterology / Vascular
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CASE 155 β€’ OPD

The Dysphagia That Changed From Solids to Liquids

The working diagnosis was esophageal cancer. Then one discordant clue forced the team to rebuild the case.

Gastroenterology
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CASE 156 β€’ OPD

The Bloating With an Unexpected Skin Rash

The working diagnosis was food intolerance. Then one discordant clue forced the team to rebuild the case.

Gastroenterology / Dermatology
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CASE 157 β€’ OPD

The Recurrent Ulcer Despite Treatment

The working diagnosis was H. pylori peptic ulcer disease. Then one discordant clue forced the team to rebuild the case.

Gastroenterology / Endocrinology
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CASE 158 β€’ Ward

The Bloody Diarrhea After Antibiotics

The working diagnosis was inflammatory bowel disease. Then one discordant clue forced the team to rebuild the case.

Gastroenterology / Infectious Disease
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CASE 159 β€’ Ward

The Abdominal Swelling With a Normal Liver

The working diagnosis was cirrhosis. Then one discordant clue forced the team to rebuild the case.

Gastroenterology / Cardiology
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CASE 160 β€’ OPD

The Weight Loss With Mouth Ulcers

The working diagnosis was nutritional deficiency. Then one discordant clue forced the team to rebuild the case.

Gastroenterology
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CASE 161 β€’ Ward

The Jaundice With a Normal Ultrasound

The working diagnosis was extrahepatic biliary obstruction. Then one discordant clue forced the team to rebuild the case.

Hepatology
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CASE 162 β€’ OPD

The Young Patient With Liver Disease and Tremor

The working diagnosis was chronic viral hepatitis. Then one discordant clue forced the team to rebuild the case.

Hepatology / Neurology
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CASE 163 β€’ Ward

The Ascites With a High Protein Level

The working diagnosis was portal-hypertensive cirrhosis. Then one discordant clue forced the team to rebuild the case.

Hepatology / Cardiology
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CASE 164 β€’ Emergency

The Confusion After a GI Bleed

The working diagnosis was hypovolemic encephalopathy. Then one discordant clue forced the team to rebuild the case.

Hepatology
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CASE 165 β€’ OPD

The Liver Enzymes That Rose With Exercise

The working diagnosis was hepatitis. Then one discordant clue forced the team to rebuild the case.

Hepatology / Muscle
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CASE 166 β€’ Emergency

The Jaundice During Pregnancy

The working diagnosis was viral hepatitis. Then one discordant clue forced the team to rebuild the case.

Hepatology / Obstetrics
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CASE 167 β€’ OPD

The Itching Before the Jaundice

The working diagnosis was allergic dermatitis. Then one discordant clue forced the team to rebuild the case.

Hepatology
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CASE 168 β€’ Ward

The Portal Hypertension Without Cirrhosis

The working diagnosis was cryptogenic cirrhosis. Then one discordant clue forced the team to rebuild the case.

Hepatology / Hematology
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CASE 169 β€’ OPD

The Hepatitis With a High Ferritin

The working diagnosis was viral hepatitis. Then one discordant clue forced the team to rebuild the case.

Hepatology
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CASE 170 β€’ Ward

The Fever With Liver Abscesses and Diabetes

The working diagnosis was amoebic liver abscess. Then one discordant clue forced the team to rebuild the case.

Hepatology / Infectious Disease
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CASE 171 β€’ Emergency

The Kidney Injury After a Marathon

The working diagnosis was dehydration. Then one discordant clue forced the team to rebuild the case.

Nephrology
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CASE 172 β€’ OPD

The High Potassium With a Normal Creatinine

The working diagnosis was renal failure. Then one discordant clue forced the team to rebuild the case.

Nephrology / Endocrinology
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CASE 173 β€’ Ward

The Edema With a Skin Infection

The working diagnosis was heart failure. Then one discordant clue forced the team to rebuild the case.

Nephrology
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CASE 174 β€’ OPD

The Kidney Failure With Hearing Loss

The working diagnosis was hypertensive nephropathy. Then one discordant clue forced the team to rebuild the case.

Nephrology / Genetics
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CASE 175 β€’ ICU

The Sodium That Rose During Treatment

The working diagnosis was appropriate correction. Then one discordant clue forced the team to rebuild the case.

Nephrology
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CASE 176 β€’ Ward

The Kidney Injury After a CT Scan That Wasn't Contrast

The working diagnosis was contrast-associated AKI. Then one discordant clue forced the team to rebuild the case.

Nephrology / Hematology
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CASE 177 β€’ OPD

The Recurrent Kidney Stones With Diarrhea

The working diagnosis was hyperparathyroidism. Then one discordant clue forced the team to rebuild the case.

Nephrology / Gastroenterology
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CASE 178 β€’ OPD

The Hypertension After a Sudden Creatinine Rise

The working diagnosis was progressive CKD. Then one discordant clue forced the team to rebuild the case.

Nephrology / Vascular
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CASE 179 β€’ Ward

The Proteinuria With a New Cancer Diagnosis

The working diagnosis was diabetic nephropathy. Then one discordant clue forced the team to rebuild the case.

Nephrology / Oncology
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CASE 180 β€’ OPD

The Acidosis With a Normal Anion Gap and Stones

The working diagnosis was chronic diarrhea. Then one discordant clue forced the team to rebuild the case.

Nephrology
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CASE 181 β€’ Emergency

The Headache With a Normal CT

The working diagnosis was migraine. Then one discordant clue forced the team to rebuild the case.

Neurology
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CASE 182 β€’ OPD

The Weakness That Improved With Repetition

The working diagnosis was myasthenia gravis. Then one discordant clue forced the team to rebuild the case.

Neurology
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CASE 183 β€’ Ward

The Seizure After Rapid Sodium Correction

The working diagnosis was recurrent epilepsy. Then one discordant clue forced the team to rebuild the case.

Neurology / Nephrology
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CASE 184 β€’ Ward

The Memory Loss With a Strange MRI

The working diagnosis was early dementia. Then one discordant clue forced the team to rebuild the case.

Neurology / Immunology
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CASE 185 β€’ OPD

The Foot Drop With Weight Loss

The working diagnosis was lumbar radiculopathy. Then one discordant clue forced the team to rebuild the case.

Neurology / Rheumatology
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CASE 186 β€’ OPD

The Tremor That Disappeared During Sleep

The working diagnosis was Parkinson disease. Then one discordant clue forced the team to rebuild the case.

Neurology
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CASE 187 β€’ Emergency

The Vertigo With a Dangerous HINTS Exam

The working diagnosis was peripheral vestibulopathy. Then one discordant clue forced the team to rebuild the case.

Neurology
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CASE 188 β€’ Ward

The Dementia That Progressed in Weeks

The working diagnosis was Alzheimer disease. Then one discordant clue forced the team to rebuild the case.

Neurology
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CASE 189 β€’ OPD

The Facial Weakness With Ear Pain

The working diagnosis was Bell palsy. Then one discordant clue forced the team to rebuild the case.

Neurology / Infectious Disease
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CASE 190 β€’ Emergency

The Sleepiness With Eye Movement Abnormalities

The working diagnosis was alcohol intoxication. Then one discordant clue forced the team to rebuild the case.

Neurology / Nutrition
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CASE 191 β€’ OPD

The Joint Pain With a Quiet Urine Abnormality

The working diagnosis was osteoarthritis. Then one discordant clue forced the team to rebuild the case.

Rheumatology / Nephrology
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CASE 192 β€’ Ward

The Sinusitis That Became Kidney Failure

The working diagnosis was recurrent bacterial sinusitis. Then one discordant clue forced the team to rebuild the case.

Rheumatology / Nephrology
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CASE 193 β€’ OPD

The Shoulder Pain With a New Headache

The working diagnosis was cervical spondylosis. Then one discordant clue forced the team to rebuild the case.

Rheumatology
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CASE 194 β€’ Ward

The Fever With Painful Red Nodules

The working diagnosis was cellulitis. Then one discordant clue forced the team to rebuild the case.

Rheumatology / Dermatology
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CASE 195 β€’ OPD

The Cold Fingers With Swallowing Difficulty

The working diagnosis was primary Raynaud phenomenon. Then one discordant clue forced the team to rebuild the case.

Rheumatology
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CASE 196 β€’ OPD

The Back Pain That Improved With Exercise

The working diagnosis was mechanical back pain. Then one discordant clue forced the team to rebuild the case.

Rheumatology
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CASE 197 β€’ OPD

The Recurrent Mouth Ulcers With Thrombosis

The working diagnosis was aphthous ulcers. Then one discordant clue forced the team to rebuild the case.

Rheumatology
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CASE 198 β€’ OPD

The Muscle Weakness With a Purple Eyelid Rash

The working diagnosis was drug myopathy. Then one discordant clue forced the team to rebuild the case.

Rheumatology / Dermatology
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CASE 199 β€’ Ward

The Dry Eyes With Low Potassium

The working diagnosis was dehydration. Then one discordant clue forced the team to rebuild the case.

Rheumatology / Nephrology
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CASE 200 β€’ Ward

The Fever With a Very High Ferritin

The working diagnosis was occult infection. Then one discordant clue forced the team to rebuild the case.

Rheumatology
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Educational use: These are synthetic teaching cases for qualified/practicing physicians and trainees. They do not replace patient-specific assessment, local protocols, specialist consultation or current guideline review.
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