solve cases and earn CREDIT*
Try these cases, they are not designed to trick you. These were real cases. Patients do not come in with their diagnosis. The provider decides what is dangerous or not. Are you ready to back up your plan with your rationale and your documentation?
Please review the following cases and provide a differential diagnosis and a workup plan. You could earn $25 credit per solved case toward CME registration fee (up to $200 per attendee).
If you have interesting cases, share with us and earn Honorarium here.
Please review the following cases and provide a differential diagnosis and a workup plan. You could earn $25 credit per solved case toward CME registration fee (up to $200 per attendee).
If you have interesting cases, share with us and earn Honorarium here.
Case 101. Acute chest pain
52 year old man had sudden onset, retrosternal chest pain, with upper back pain between shoulder blades with a tearing sensation at home. The pain radiated to his epigastric area. He called you for advice. What is the differential diagnosis.
Case 102. Hip and leg pain
73 yo lady developed a left hip and leg pain after a long drive of 11 hours about 10 months ago. She had lumbar spine X ray/MRI which showed mild to moderate DDD. She had lumbar epidural steroid injection done yet pain persisted. She declined a spine surgery consult. She came for 2nd opinion. Pleas explain what is the differential diagnosis and further workup if needed.
CASE 103. Thigh pain
51 year old lady had a chronic medial thigh pain with burning sensation and wobbly gait. What causes this pain and her gait problem?
CASE 104. THIGH PAIN
34 year old obese man with a burning pain on the lateral aspect of his left thigh. What is your diagnosis and what would be a possible injection for this pain. What is the ICD -10 code and CPT code. What is the Medicare rate for this procedure.
CASE 105. Shin PAIN
A 16 year old avid tennis player developed a moderate pain over her right lower shin. What is this pain? What is the treatment option.
CASE 106. wrist PAIN
35 year old male bicycle rider developed a wrist pain after a long training session without trauma nor fall. Moving his right wrist hurts. What s the most likely diagnosis. What is the potential procedure and its CPT code.
CASE 107. Elbow PAIN
30 year old male developed a lateral elbow pain after a session of tennis. Moving his right wrist hurts his elbow. WHat's diagnosis. What is the potential procedure and its CPT code.
CASE 107. arm PAIN
76 year old lady decided to clean up her house. She then developed a severe right forearm pain if she rotated her forearm medially. Also she had a peculiar finger weakness similar to what is shown in the right panel. She could not pick up small things using her right thumb and index finger nor could she wind her old watch. How do you workup and what is the diagnosis. What is the potential procedure and its CPT code.
CASE 108. Shoulder PAIN
10 year old avid soccer player had an intense match with several falls but no bruise nor broken bone but developed a left posterior shoulder pain as shown by a star and a left lateral shoulder patchy hypoesthesia. She also had difficulty raise her left shoulder and arm. Dad sought an orthopedic doctor who then referred her to a pain doctor. What can be said about this unique presentation. IF a injection can be done, what is the potential procedure and its CPT code?
CASE 109. Hand tingling
50 year old man with above area of numbness and tingling. What is the lesion and where is the lesion. What is the potential procedure and its CPT code.
CASE 110. Hand tingling
25 year old newlywed stayed late in a bar with his new wife on their honeymoon. The next morning, he had this pain, tingling and numbness over his right dorsal hand and weakness of his wrist. What was his problem?
CASE 111. Chest PAIN
87 year old man retired navy sailor during WWII with 6 month history of left chest and shoulder pain as shown. He lost his wife of 62 years 9 months ago. Pain was always there and worse at night. He had been to PMD x3; urgent care x 2 and ED x 2 and was admitted to hospital once for an extensive cardiology workup (Chest X-ray,EKG, and nuclear stress tests) which were negative. He was referred to a pain doctor to treat his pain. What is the diagnosis and plan.
CASE 112. Buttock PAIN
66 year old chronic smoker and type II DB developed a left buttock pain after a ski trip to King's mountain, PA 8 years ago. The pain only occurs when he walks a certain distance. It resolves readily if he stops walking. Climbing stair also provokes his buttock pain in a similar manner except the pain comes on much quicker. Such pattern of pain and relief is reproduced with 100% fidelity with walking. He sought out many doctors in many specialties over many years without sustained pain relief. He is severely limited with his walking. He is then referred to a pain doctor by his endocrinologist. What is his problem?
CASE 113. Chest PAIN
61 year old man with 10 months of left lateral chest pain. He has chest wall surgery done about 30 year ago to fuse both layers of pleura due to frequent spontaneous pneumothorax. For this chest pain, he was seen by PMD, chest X ray and chest CT with 3 mm thin-cut were done and no pathology nor cause for pain was reported. They did find old scar from his surgical site. He was sent to a pain doctor for pain management. What is the diagnosis and plan?
CASE 114. Abdominal PAIN
63 year old man with right upper quadrant abdominal pain 6 months and acid reflex disease referred by his GI doctor (after clear for GI issue) for pain management. The pain is worse with spicy food and incumbent position. He had anorexia. But the physical examination failed to reproduce any pain. A chemistry panel for GI profile showed 2-3 time elevated pancreas lipase enzyme and ~ x1 elevated amylase level. Hepato-biliary profile was normal. What is his pain and plan.
CASE 115. No PAIN
This was the best a patient could do when he was asked to extend his right wrist, hand and fingers. Where was the lesion.
CASE 116. Hand
This was the best a patient could do when he was asked to spread his fingers. Where was the lesion.
CASE 117. Abdominal pain
73 year old man stage 4 prostate cancer controlled on ADT was on vacation when he developed fulminate general abdominal pain, fatigue and lethargy, and shock refractory to 3 pressors. Repeated whole body CT scan failed to provide explanation for his abdominal pain. He was diagnosed and treated for sepsis (with several antibiotics) and septic shock. Despite of heroic effort he passed away in days. What was the alternative diagnosis that could explain his syndrome.
CASE 118. THIGH PAIN
67 year old man with 35 year history of right posterior thigh pain. He sought out many doctors in many specialties over many years with several L-spine MRI and epidural steroid injection without any pain relief. He is severely limited with his walking. He is then referred to a pain doctor by his niece. Pain was reproduced as shown. What was his problem? What is the potential procedure and its CPT code.
* Once submitted, upon review and approval, you will receive $25 credit per case toward any CME live program within 36 months. Credit has no cash value but can be redeemed at registration of CME via an issued coupon. It is non-transferable to other providers. It can be combined with other credit but no more than $200 can be used toward any single live CME per person.