The Clinical Problem Solvers

Hosts exchange humorous anecdotes and dive into a fascinating clinical case involving a patient with a forehead mass. They discuss the diagnostic process, revealing CT findings that suggest osteomyelitis. The conversation shifts to exploring potential infectious causes, highlighting the importance of thorough testing. The surprising diagnosis of secondary syphilis as the culprit for skull osteomyelitis underlines the need for clinical reasoning in rare cases. A mix of levity and serious medical insight makes for an engaging discussion.

Dr. Yousuf Patel, a neurology resident from Cape Town with diverse medical training, presents a compelling case of diplopia and fever. He dives into distinguishing types of diplopia and the crucial role of the medial longitudinal fasciculus in gaze coordination. The discussion uncovers potential infectious causes linking fever with diplopia, addressing key diagnostic elements. A surprising link to Behçet's syndrome emerges through patient history and MRI findings, showcasing the importance of a thorough examination in uncovering complex neurological disorders.

A riveting case unfolds with a 65-year-old patient presenting severe dyspnea and anemia. The hosts dissect the diagnostic challenge of schistocytes and pinpoint their role in hemolysis. They navigate through critical lab findings and imaging, uncovering a potential malignancy linked to the patient's condition. Insights on the relationship between adenocarcinoma and hemolytic anemia provide a deeper understanding of marrow infiltration. The case culminates in a treatment response, emphasizing the importance of early diagnosis and lab sensitivity.

In this discussion, Dr. Kriti Prasad, an internal medicine resident researching clinician burnout, teams up with Dr. Khaalisha Ajala, a hospital medicine professor and founder of A Tribe Called Health. They explore the toll of clinician burnout, emphasizing its links to racial health inequities and moral injury. The conversation reveals how COVID exacerbated these challenges and discusses actionable policy changes needed to support clinician wellbeing. They highlight the importance of reclaiming rest and fostering a healthier medical culture for better patient care.

A captivating case of dyspnea with ground-glass opacities unfolds as the hosts tackle diagnostic challenges. They explore the anatomy behind hypoxia and discuss community-acquired pneumonia's diagnostic criteria. Delving into the patient's history reveals bird exposure and potential mold triggers. Discussion shifts to balancing antibiotic use and viral testing amidst exclusion of infections. As the plot thickens, findings lead to a diagnosis of hypersensitivity pneumonitis, with an emphasis on management through exposure removal and ongoing follow-up.

In an engaging discussion, the hosts dive into a complex case of a patient facing dizziness and dyspnea. They explore the critical role of anemia in diagnosing symptoms. The team assesses the implications of severe iron deficiency and debates the necessity of transfusions. As they analyze potential causes of occult bleeding, the suspense builds. The revelation of esophageal adenocarcinoma from endoscopic evaluations highlights the challenges in diagnostic medicine. Listeners gain insights into effective clinical reasoning and the importance of thorough investigation.

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Join UCLA Cardiology fellows Dr. Angela Duvalyan and Dr. Rachel Ohman as they dissect a compelling case of a 49-year-old woman with acute chest pain. They navigate through critical differential diagnoses like acute coronary syndrome and the significance of presyncope. The discussion delves into the intriguing findings from the echocardiogram, highlighting hypertrophic cardiomyopathy and its management. The fellows also emphasize the role of cardiac MRI in diagnosing complex cardiac conditions, all while maintaining a focus on patient-centered care.

Greg Kirshen, a maternal-fetal medicine specialist, and Bobby Brar, a fellow in maternal-fetal medicine and clinical genetics, join Anna Jarvis, an OB/GYN resident, to discuss a complex case involving a 10-week pregnant woman with severe abdominal pain and large-volume ascites. They explore differential diagnoses, including infection and malignancy, and share insights on management strategies. The conversation emphasizes the importance of a broad differential and offers practical counseling for future pregnancies.

Masha Slavin, Harita Shah, and Sarah Kimball, experts in immigrant and refugee health, share powerful insights from their diverse backgrounds in medicine. They discuss the impact of racism on healthcare access, highlighting systemic barriers like language and immigration policies. The conversation covers the multifaceted challenges immigrant populations face, emphasizing the importance of culturally sensitive care. They also advocate for community-engaged research and collaboration, aiming to build sustainable partnerships that improve health outcomes for underserved groups.