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🔝Case#1: ID 0504926
🔝Topic: Hematology, Pharmacology

A 65-year-old woman undergoes an elective total knee arthroplasty. On post-operative day 4, while on prophylactic unfractionated heparin, she is found to have a platelet count of 45,000/microL, decreased from a baseline of 250,000/microL. A peripheral blood smear does not show schistocytes. Her serotonin release assay is positive. Doppler ultrasonography of her lower extremities is negative for deep vein thrombosis. Her skin manifestation is shown in the picture.

🔝Case#2: ID 05011016
🔝Topic: Cardiovascular system

A 64-year-old woman presents to the emergency department with sudden chest discomfort. She describes the pain as a "crushing" sensation, which began while walking her dog, radiating to her left shoulder and jaw. She is nauseous and feels lightheaded. On examination, her BP is 130/80 mmHg, pulse 86 bpm, and RR 20/min. An ECG is shown in the picture.

🔝Case#3: ID 05041928
🔝Topic: Hematology and Oncology

A 58-year-old male presents with a 6-month history of headaches, vision changes, and increasing forgetfulness. An MRI of the brain reveals a large, enhancing mass in the right temporal lobe consistent with Glioblastoma. He undergoes tumor resection and subsequently starts chemotherapy with nitrosoureas. Four weeks into treatment, routine labs reveal increased liver enzymes, a drop in white blood cell count, and thrombocytopenia.

🔝Case#4: ID 0105923
🔝Topic: Pharmacology

A 72-year-old male with a history of atrial fibrillation, hypertension, and chronic kidney disease is currently taking warfarin, metoprolol, and furosemide. His most recent international normalized ratio (INR) was therapeutic at 2.5. Due to a recent diagnosis of gastroesophageal reflux disease (GERD), his primary care physician prescribed a new medication. One week later, he presented to the emergency department with coffee-ground emesis and melena. Lab results show an elevated INR of 6.8. An ECG shows normal sinus rhythm.

🔝Case#5: ID 05021021
🔝Topic: Endocrinology

A 45-year-old male presents to the emergency department complaining of flushing and dyspnea, which he describes as bronchospasm. He has a history of diabetes mellitus and is taking metformin and aspirin. Additionally, he reports frequent diarrhea over the past month. His initial vital signs are stable, but he appears uncomfortable and flushed. CT scan was performed and shown in the picture.

🧪Laboratory Data:
Serum Glucose: 180 mg/dL
5-Hydroxyindoleacetic Acid (5-HIAA): Elevated

🔝Case#6: ID 02031023
🔝Topic: Metabolism

A 28-year-old man consults his physician for complaints of jaundice, loss of appetite, and fatigue. He arrived from Europe 3 days ago, is not married, and does not drink alcohol or smoke. Physical examination reveals icteric skin on his face and palms, as well as icteric sclera. Ultrasound of the gastrointestinal tract is unremarkable.

🧪Laboratory findings:
Red Blood Cells: 4.7 x 10^12/L
Leukocytes: 6.11 x 10^9/L
Platelets: 210 x 10^9/L
Hemoglobin: 135 g/L
ESR: 5 mm/hour
Indirect Bilirubin: 25.8 µmol/l
Direct Bilirubin: 4.5 µmol/l
ALT: 13.64 U/L
AST: 14 U/L