Test your knowledge and clinical acumen with JAMA Network Clinical Challenges. Can you make the diagnosis and order the next best test or treatment?
A 59-year-old man taking warfarin for recurrent VTE has a point-of-care (POC) international normalized ratio (INR) value of 3.7 (target 2.0 to 3.0). What would you do next?
A 45-year-old woman with a history of a left vocal fold polyp presented with hoarseness. What is your diagnosis?
An asymptomatic 57-year-old man with obesity, hypertension, and dyslipidemia requests screening for diabetes. Would you offer laboratory-based or point-of-care glucose or HbA1c testing?
A man presents with headache, double vision, and seizures for 1 month. Cranial magnetic resonance imaging showed 2 ring-enhancing brain lesions with thin-walled, contrast-enhancing rims and central liquefaction. What is your diagnosis?
This case report describes the use of an extended butterfly graft for functional and cosmetic correction of saddle nose deformity.
A newborn with 22q11.2 deletion syndrome, tetralogy of Fallot, and unilateral renal agenesis presented at birth with a right neck mass and intermittent inspiratory stridor. What is your diagnosis?
A girl in her teens presented with punctate keratotic papules on the palm and third finger, which had been present since the age of 2 years. What is your diagnosis?
A 43-year-old African American man presented with a nontender, self-palpated mass in his left breast. Physical examination showed retraction of the nipple and a 3.5 × 3.0–cm firm mass, with no axillary lymphadenopathy. Mammography showed a partially obscured left upper quadrant mass with extension to the nipple, and targeted ultrasound showed an irregular hypoechoic mass. What is the diagnosis and what would you do next?
A man in his 50s with a history of itchy eruptions presented with extensive dry, scaly patches and nodules on his trunk and extremities. What is your diagnosis?
A woman in her 50s presented with erythematous annular atrophic plaques on bilateral breasts after undergoing breast augmentation procedures. What is your diagnosis?
A 79-year-old woman presented to the eye emergency department with right eye pain and photophobia after Descemet stripping automated endothelial keratoplasty. What would you do next?
An 81-year-old man presents with a gradual decline in his vision bilaterally over 2 years and a chronic cough. What would you do next?
A 25-year-old man presented to the emergency department with rapidly decreased visual acuity and exceptionally high intraocular pressure in both eyes. What would you do next?
A 53-year-old man presents with a bulging left eye, several eyeglass prescription changes in the left eye over the past 2 years, and frequent ipsilateral tearing. What would you do next?
A man in his 50s with nonalcoholic steatohepatitis and hepatocellular carcinoma undergoing checkpoint inhibitor therapy experiences weakness and myalgia. What is your diagnosis?
An 18-month-old girl presents with an intraocular mass near the optic nerve. What would you do next?
A woman in her 50s with a history of metastatic human papillomavirus cervical adenocarcinoma presented with multiple joint deformities. What is your diagnosis?
A man in his 50s with polyarticular inflammatory arthritis presented with numerous pink-purple papules on the trunk and extremities. What is your diagnosis?
A 30-year-old man presents with involuntary orofaciolingual movements for 7 years and unsteady gait for 2 months. What is your diagnosis?
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: