New Palpable Mass in Right Breast
Condition History and physical Features Fibrocystic change Vague irregularity of breast tissue (lumpy breast), often in upper quadrants, cysts have a blue-dome appearance on exam Most common breast mass in…
Abnormal Screening Mammogram
Select benign calcifications Skin calcifications May be secondary to dermatitis or hygiene products (e.g., deodorants, ointments) Vascular calcifications Linear or parallel tracks; may be associated with underlying vascular disease Coarse…
Right Leg Pain, Swelling, and Erythema for Two Days
Condition Comments Necrotizing soft tissue infection Acute infection of the deep fascia, often with crepitus, bullae, and necrosis of the subcutaneous tissue, mixed flora Cellulitis Infection of the deep dermis…
Recently Changed Skin Lesion
Diagnosis Malignant? Comments Junctional nevi No Dark, flat, smooth lesions. They are occasionally hairy and develop from the basal layer of epidermis. Nevi that are located on the palms and…
Chronic Right Hand Pain
Etiology Differential diagnosis Vascular Thoracic outlet syndrome, vasculitic neuropathy Infectious Medical neuropathy (e.g., leprosy, Lyme disease, HIV, hepatitis, post-herpetic neuralgia) Neoplastic Pancoast tumor invading brachial plexus, intracranial neoplasm, peripheral nerve…
Lump on Neck Increasing in Size
Condition Comments K – congenital Thyroglossal duct cyst Midline mass, moves with tongue protrusion; may become infected; most common congenital neck anomaly Branchial cleft cyst Lateral to midline; at risk…
Neck Pain and Paralysis Following Trauma
Fig. 24.1 (a) Lateral radiograph and (b) computed tomographic scan (Reprinted from Youmans Neurological Surgery, Vollmer DG, Eichler ME, Jenkins III, AL, Assessment of the cervical spine after trauma, pp….
Neck Mass that Moves with Swallowing
Diagnosis Description Characteristics Thyroglossal duct cyst Congenital persistence of thyroglossal duct Well-defined, smooth neck mass located in the midline, above the cricoid cartilage; elevates with tongue protrusion (swallowing) Multi-nodular goiter…
Bright Red Blood per Rectum
Disease Etiologies Risk factors Clinical presentation Diverticulosis (30–50 %) Arterial bleed from vasa recta at base of diverticula Advanced age, lack of fiber, obesity Painless bright red blood per rectum…
Aural Fullness, Hearing Loss, and Tinnitus
Diagnosis History and physical Acute otitis media (AOM) Otalgia, fever, bulging and erythematous TM with decreased mobility, poor light reflex; duration < 3 weeks Otitis media with effusion (OME) Middle ear effusion…
