Acute Bacterial Endocarditis

ID CC A 25-year-old male complains of increasing shortness of breath and ankle edema that have progressively worsened over the past 2 weeks. HPI He also complains of fatigue, palpitations, and low-grade fever. His symptoms followed a severe URI. He denies any history of joint pain or skin rash (vs. rheumatic fever). PE J VP elevated pitting pedal edema line inspiratory crepitations heard at both lung bases mild hepatosplenomegaly. Labs ASO titers not elevated. CBC lymphocytosis. EGG...

Herpes Genitalis

ID CC A 45-year-old HIV-positive male is seen by his family doctor following the appearance of a painful, burning skin rash on the left side of his chest that is accompanied by a headache and low-grade fever. HPI The patient had chickenpox as a child. He had been well until 1 year ago, when he was diagnosed with non-Hodgkin's lymphoma, for which he is currently undergoing chemotherapy. PE Vesicular rash on erythematous base in dermatomal distribution (left T6-T8) exquisitely tender to touch....

Pityriasis Versicolor

ID CC An 18-month-old male is brought to the pediatrician following the appearance of an extensive skin rash. H PI Four days ago he suddenly developed a very high fever (40 C) with no other symptoms or signs. The fever continued for 4 day until the day of his admission, when it abruptly disappeared, coinciding with the onset of the rash. PE Child looks well in no acute distress generalized rash apparent discrete 2- to 5-mm rose-pink macules and papules on trunk, neck, and extremities (face is...

Urticaria

ID CC A 7-year-old male is brought to his family physician complaining of a thick yellowish discharge in his eyes that prevents him from opening his eyes in the morning for the past few clays, his eyes have been blood-red, painful, and watery. His eye pain is exacerbated by exposure 10 light (photophobia). HPI Three of his classmates and a neighbor had a similar episode about 7 days ago (suggesting a local epidemic of such cases). PE VS no fever. PE normal visual acuity erythematous palpebral...

How To Use This Book

This series was originally developed to address the increasing number of clinical vignette questions on medical examinations, including the USMLE Step 1 and Step 2. It is also designed to supplement and complement the popular First Aid for the USMLE Step 1 (Appleton 8c Lange McGraw Hill) and First Aid for the USMLE Step 2 (Appleton & Lange McGraw Hill). Each UCV 1 book uses a series of approximately 100 supra-prototypical cases as a way to condense testable facts and associations. The...

Hepatitis A

ID CC A 25-year-old male medical student presents with jaundice and dark yellow urine. HPI He admits to having experienced an accidental needle stick 2 months ago, which he did not report. He also complains of nausea, low-grade fever, and loss of appetite. PE Icterus tender, firm hepatomegaly no evidence of ascites or splenomegaly. Labs Direct hyperbilirubinemia elevated serum transaminases (ALT > AST) mildly elevated alkaline phosphatase HRsAg positive IgM anti-HBc positive (present during...