We want to develop here real clinical situations with a patient, enhancing the importante of the cognitive and systemic aspects involved in a clinical decision. We believe this way is the best to teach clinical practice.
Author: Lorenzo Alonso
FORO OSLER
A 57-years-old-man had a diagnosis of kidney cancer with bone metastases including the spine. He was receiving treatment with immunotherapy. One week before the hospital consultation, he started with back pain, walking difficulties, a feeling of weakness in both legs, with difficulty in urination. He has had no fever Continue reading “My legs are very weak and my back hurts so much”
Participants
The doctor The patient The hematologist
Clinical summary
A-52-year-old woman treated with immunotherapy after a diagnosis of melanoma. Four months after the first treatment, the patient started with petechiae and ecchymosis widely distributed along her skin.
Continue reading I know that the patient is bleeding, but why? Not always Yin or Yan
The patient The Oncologist
The Pulmonologist
A 42-year-old woman had a diagnosis of metastatic breast cancer. She started treatment with chemotherapy, but ten days after her first cycle she went to the Emergency Department with symptoms of dyspnea, a non-productive cough and fever. Her blood test showed a normal hemoglobin, platelets and white cell count. Continue reading The lung secret code: who will survive? When bronchoscopy is not possible
This is the case of a -62-year-old woman with a diagnosis of gynecologic cancer and a pulmonary embolus. She was receiving chemotherapy and a therapeutic dose of a low-molecular-weight-heparin (LMWH) . She had a single daily dose of a 1,5 mg/per Kilo, calculated in base on her body weight.
A 76-year-old woman had a diagnosis of metastatic colon cancer. After surgery and chemotherapy, there was only a solitary metastasis in her right hepatic lobe, close to the capsule. The oncologist decided to treat this metastasis with radiofrequency. Continue reading “Blindness” to another problem during the COVID-19 pandemic: a clinical case
A 50-year-old woman without previous diseases went to the Emergency Department (ED) because in the last week she started with pain in her abdomen and vomiting after eating. She was a heavy smoker with two episodes of right ureteral lithiasis four years ago.
Continue reading Do you think it could have been done better? Abdominal pain, nausea and vomiting