Clinical Challenge Articles

Pain and hardening of the skin constricts shoulder movement

Shailendra K Saxena, MD, PhD; Nirmal K. Phulwani, MD; Shikhar Saxena, MD; Jyoti Khatri, MD; and Naureen Rafiq, MD September 01, 2010

Had the patient agreed to a biopsy, the diagnosis may have been made sooner.
 

Blood-collection device leads to low platelet count

Gregorio Hidalgo, MD; Lizmer Díaz, MD; and Nishu Karki, MD September 01, 2010

A misdiagnosis would have led to unnecessary tests and treatment.
 

An antipsychotic's side effects derail a patient's symptom management

Heidi Magyar, MS, ARNP August 01, 2010

After five years of treatment without side effects, his glucose level took off.
 

Bacterial meningitis complicated by 
seizures and confusion

Stephanie Christian-Lobley, FNP-BC, APNP, CCRN, CNRN July 01, 2010

The seizures began following surgery to repair a cerebrospinal fluid leak.
 

Prescription and OTC creams ineffective against itchy lesions

Bridget E. Harcus-Wickersham, RN, FNP, DNP June 01, 2010

The patient's physical and psychological discomfort upset every aspect of his life.
 

Drastic weight loss and bone deformities in a breastfed infant

Ami Goldstein, MSN, CNM, FNP May 01, 2010

Could the mother's religious custom of wearing a full veil at all times have played a role in the child's illness?
 

Severe muscle spasms and jaw stiffness after stepping on a nail

April 01, 2010

The symptoms began 10 days after the accident. Steroids provided no relief, 
and diagnostic tests were inconclusive.
 

New onset of lower extremity weakness 
after a viral illness

Renee Wenzlaff, DNP March 01, 2010

Upper respiratory infection triggers complications in a healthy college student.
 

An infrequent cause of chronic cough

Guada Respicio, MD January 29, 2010

A number of diagnostic possibilities are raised, including allergy, asthma, postnasal drip, and reflux.
 

Cutaneous symptoms uncover unintentionally obscured disease

Matthew S. Rice, LTC, MC, USA January 29, 2010

As a nurse, the patient had access to many informal opinions. Would a proper evaluation have led to a quicker diagnosis?
 
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