Diagnostic Atypia

Kicking off a new series dedicated to management reasoning, Andrew presents a case of "dark stools" after recent UGIB. Occam's razor vs Hickam's dictum?

Mike presents the case of a man with painless vision loss and new colorblindness. The retinal exam suggests ischemic vs inflammatory causes. Are acute symptoms always explained by acute diseases?

Dr. Jeffrey Shen presents a perplexing case of a patient with symptoms across nearly all organ systems with some non-specific positive tests but no unifying diagnosis. How can testing characteristics obscure even the most common diagnoses? What does it take to say that a disease has been truly "ruled out?"

Andrew presents the case of a woman with subacute fatigue but no localizing symptoms. On arrival, every lab is flashing red. The diagnosis remains elusive, but seems so obvious in reflection. Can you recognize the illness script?

Mike presents the case of a recently hospitalized man readmitted to the hospital for altered mental status with neuropsychiatric features. The case escalates without a diagnosis until suddenly he's "cured." The only issue? You treated with so many agents simultaneously that now you have no idea which one to keep. Turns out, his nurse holds the final clue.

Mike works through a case of new-onset ascites, where every test comes back negative. Or did they? When we don't know what test to order next, sometimes the best approach is to reconsider the results we already have. What is hiding in plain sight?

Dr Nicholas Salter presents the case of an elderly woman evaluated in the ED for confusion & bradycardia. What if the disease marker can cause the disease itself?

Dr. Brendan Robinson presents a case of refractory shock after recent CABG. As the 4th pressor is hung, Andrew and Mike realize they don't have the "tincture of time" in this one. Join us for an all-out scramble through the shock differential!

Dr. Zaven Sargsyan presents the case of a female patient with the scariest rhythm of them all. The final diagnosis is extremely common, but the path to get there? Let's just say the horses still seem to be wearing their Zebra costumes from Halloween.

"I'm here for my leg, doc" *cough cough*

Grab your RBC inner tube and come flow down the coagulation cascade with us! But let's not forget what lies upstream...

A patient arrives to the emergency department with chest pain. You can make the diagnosis before even placing your stethoscope on his chest, but only if you're looking closely. Make your Intro to Physical Exam professor proud by remembering, "First, you must inspect."

Dr. Austin Rezigh joins us to present the case of a woman in clinic with chronic progressive lower extremity weakness & pain. When every lab and study is flashing red, how do you sort the red flags from the red herrings?

Mike provides the results for each potential answer choice from last week. Andrew then discusses his approach to the case, revealing the final diagnosis at the end!

Season 2 is here! We kick off the new season with a fun twist on our usual format. This week, Mike presents a case to YOU of recurrent post-prandial abdominal pain and then leaves you with a question. Next week, we'll provide the answer with Andrew's reflections.

Mike presents a case of atraumatic rhabdomyolysis in a patient with worsening lower extremity weakness. Testing will take weeks to return. How do we approach management when we don't have all the answers yet?

Andrew presents a case of acute "red leg" overlying a chronically deformed joint. Is it infectious, or a flare of something else?

Mike presents a case of back and dysuria with a challenging endpoint diagnosis. How far can you get without tissue?

Dr. Maddy Conte joins us to discuss a case of pancytopenia. Come flex your blood smear skills!

Andrew presents a case of a common cross-cover call: AFib w/ RVR. Once rate-controlled, she looks well & euvolemic. The CXR is normal, but SpO2 92%. Are you done?

Andrew presents a case of a young patient with obesity admitted for a few days of recurrent falls. All of a sudden, you're called to a rapid response for altered mental status. How can patient characteristics alter the tempo of common diseases?

Dr. Alec Rezigh joins the show for our first-ever guest episode ("Guestpisode") to present a case of subacute cough. The differential is blown wide open by some abnormal imaging. Are you ready to correlate clinically?

Mike presents a case of severely elevated transaminases in a patient with abdominal pain & fevers. The social history is king here, & it isn't the only king in the room...

Andrew presents a seemingly straightforward case of AKI. However, after the dust settles, the patient is then found to have tender bone lesions. Join us to learn how radiographic findings sometimes lead to more questions than answers.

Mike presents a case of recurrent transient diplopia where the answer is lying just below the surface!

Andrew presents a case of severe anemia that challenges the classic board exam schemas. How can a common lab test trick us and help us at the same time? Associated teaching available at DxAtypia.com.

Mike bamboozles Andrew with a case of acute fever & rash. How far can a common, worldwide disease bend the script? Associated teaching available at DxAtypia.com. (Note: co-hosts are aware of changes to audio at end of episode. Sorry about the technical difficulties!)

Inspired by the Diagnosis community (e.g. The Clinical Problem Solvers), Drs. Michael Arcieri (@ArcieriMichael) and Andrew Sanchez (@ASanchez_PS) present a new podcast space for Dx enthusiasts to experience diagnostic dilemmas encountered on the general medicine wards and medical ICU service. From puzzling symptoms to rare conditions, Drs. Arcieri and Sanchez highlight the twists and turns of atypical diagnostic journeys. Clinicians and students are invited to bring thought-provoking cases for group reflection ([email protected]).

Andrew presents a case of left-sided pleural effusion with 2 unexpected twists. In what ways can blood contaminate a specimen? Associated teaching available at DxAtypia.com