Reasoning, unfolded
Think it through, stage by stage.
Each case opens like the real thing — a patient, a set of vitals, a decision. Work the reasoning, reveal the answer, and keep the pearl. This is how the exam actually tests you.
Throat Tightness After Dinner: Anaphylaxis with Airway Compromise
A 24-year-old woman is brought to the ED 15 minutes after eating shrimp at a restaurant. She has…
Open case →Sudden Right-Sided Weakness and Aphasia in a 68-Year-Old Woman
A 68-year-old woman is brought to the ED after her husband witnessed the sudden onset of right-s…
Open case →Collapse After Knee Replacement: High-Risk Pulmonary Embolism
A 64-year-old woman presents 6 days after total knee arthroplasty with the sudden onset of sever…
Open case →Hematemesis in a Man with Known Cirrhosis
A 58-year-old man with alcohol-related cirrhosis (Child-Pugh B) presents after vomiting bright r…
Open case →Right Lower Quadrant Pain in a Young Adult
A 22-year-old man presents with 18 hours of abdominal pain that began periumbilically and later …
Open case →Sudden Pelvic Pain and Syncope at 7 Weeks
A 27-year-old woman presents with sudden severe right lower quadrant pain that began 1 hour ago,…
Open case →The 21-Day-Old With a Fever
A 21-day-old, full-term, previously healthy boy is brought in by his parents for a rectal temper…
Open case →The Wheezing Infant in December: Bronchiolitis vs Asthma
A previously healthy 9-month-old is brought to the ED in mid-December with 3 days of nasal conge…
Open case →Agitation and Tremor After a New Pain Medication
A 28-year-old man with major depressive disorder maintained on fluoxetine presents with 8 hours …
Open case →New Diabetes, Dangerous Pressure
A 54-year-old man with no prior medical care presents with 6 weeks of increased thirst, frequent…
Open case →