46 year old male presented with a one month history of short | Figure 1

46 year old male presented with a one month history of shortness of breath. On examination his chest was interestingly clear, and there were no signs of fluid overload, however he had this generalized rash all over his body. Thoughts?

A 16 year old boy was brought by his parents to ER. Four days ago after playing football he stepped over a dirty nail on his way home. He didn’t pay much attention to his wound and did not wash it rapidly. He now presents with difficulty in opening his mouth and his parents describe his jaw: “Like a lock”. He has no pain in his jaw. His mouth angles are raised, his neck is rigid as well as his abdomen. His back looks like an arch.
What is your provisional diagnosis?
What are other possible clinical features to look for?
What is the causative organism? By which mechanism does it cause this disease?
What are other diseases that can mimic such presentation?

A section of intestinal worm removed from the small bowel of an Afghan local national at laparotomy for gunshot wound. The bullet that perforated his small intestine in multiple places actually entered through his upper thigh, travelled through his pelvis, shredded his small intestine and lodged in his diaphragm. I'll post that case study soon!

17 year old male with rash under his arm, and on his thigh. Any idea what this is?

This man presented to the ED with a basal cell on his posterior scalp that has been there for 18mo. He also had a 6-7cm lesion on his right neck and a 3cm lesion on his left cheek. He was admitted for having intermittent fever and chills for the past several weeks with a possible melanoma on his back. #Basal-cell-carcinoma

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?