Pericardial Tamponade<div id="article-content-body"><p>A 70-year-old woman with no previous medical problems had had progressive dyspnea and generalized weakness for the past several days. She was hypotensive (73/31 mm Hg), tachycardic (120 beats per minute), and tachypneic (28 breaths per minute); oxygen saturation (room air) via pulse oximetry was 84%. </p></div>
Formication<div id="article-content-body"><p>The father of a 28-year-old man accompanied his son to the emergency department (ED) for evaluation of a “worm infestation.” About 6 weeks earlier, the patient had diarrhea for 2 days and claimed to have seen worms in his stool. He went to an urgent care clinic, but it was unclear as to whether he received a diagnosis or prescription. </p></div>
Gouty Tophi<div id="article-content-body"><p>A 33-year-old man presented with joint pain and general malaise of about 2 weeks' duration and small yellowish lesions on the pinnae of the ears of about 6 months' duration. He had no urinary symptoms or conjunctivitis and was not taking any medications.</p></div>
Aortitis<div id="article-content-body"><p>An obese 61-year-old man who had chronic obstructive pulmonary disease and sleep apnea heard a “pop” in his stomach while lifting a heavy weight; severe abdominal pain followed. He was short of breath the next morning, and his physician empirically prescribed cephalexin. </p></div>
DermatologyFor several months, a 49-year-old woman has had asymptomatic loss of pigment on her shins. She has no history of injury to the area.