The Clinical Problem Solvers Episode 409 – Spaced Learning Series: Lung, Bones, and Brain
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Jul 24, 2025 A team of medical graduates tackles a case of a 40-year-old man involved in a motor vehicle accident who later develops a stroke. They dissect the complexities of diagnosing stroke in young patients, the nuances of lytic bone lesions, and the significance of imaging in identifying ground glass opacities in lung scans. They also unravel a perplexing medical mystery involving persistent fevers and neurological symptoms, leading to the diagnosis of disseminated coccidioidomycosis. Collaborative problem-solving takes center stage in this engaging discussion.
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Broad Differential for Young Stroke
- A young patient with stroke and systemic symptoms requires considering a broad differential including stroke mimics and infections.
- Early brain imaging showed stroke signs, but subacute cough and back pain suggested a systemic disease process.
Stroke in Young: Think Beyond
- Stroke in a young patient with no typical risk factors suggests cardioembolic, vasculitis, or hypercoagulable causes.
- Infectious, inflammatory, and cancer causes must be considered when systemic signs are present.
Stroke Etiologies: Think Systemic
- Hypercoagulable states, cardioembolic sources, and vasculitis are key considerations in unexplained stroke.
- Subacute cough and neurologic symptoms raise suspicion for systemic vasculitis or infectious etiology.
