58-Year-Old Woman With Melena

A 52-year-old woman with asymptomatic annular erythematous plaques

A 52-year-old woman sought medical attention because of several annular erythematous lesions with central clearing on her body since seven months ago. No pruritus or burning sensations were noted. Her medical and family history was unremarkable. Her Fitzpatrick skin photo-type was II. On dermatological physical examination, there were several annular erythematous plaques with raised borders and...

A 48-year-old Man with Epigastric Pain and Melena

A 48-year-old male patient was presented to the emergency department with complaint of epigastric pain and melena that had started 3 days ago. The pain had started suddenly and progressed and after a while, he had passed melena stool. He also mentioned some episodes of vomiting that was not bloody. The pain score was about 8/10 (based on verbal quantitative scale) and slightly radiated to his b...

A 58-year-old woman with progressive vertigo, deafness and weakness.

A 58-Year-Old Woman with Abdominal Symptoms and Elevated C-Reactive Protein

A 58-year-old woman presented to her primary care physician in April 2002 complaining of troubling abdominal symptoms. She described abdominal bloating and pain with frequent diarrhoea and modest weight loss. There was no history of fevers or rigors. She had a background of irritable bowel syndrome, monoclonal gammopathy of uncertain significance (MGUS), ureteric stones, hysterectomy, and fract...

Clinical Reasoning: A 58-year-old woman with loss of vision in her left eye.

SECTION 1 A 58-year-old woman developed painless visual loss in her left eye over several days. She described the vision in her left eye as “similar to looking through a dirty screen door.” She denied double vision and eye pain but reported frontal throbbing headaches associated with nausea over the preceding months. Two weeks before presentation, she had several days of nausea and vomiting tha...