JT-CR-183 · Mental, behavioral, and substance-use health
Series
Hypothermia, Bradycardia, and Altered Mental Status
An environmental emergency case on gentle handling, staged rewarming, arrhythmia risk, and endocrine or toxic mimics.
Daily clinical reasoning series
April 2026
30 case-based clinical reasoning analyses assigned to the daily casebook sequence for April 2026.
Case-series dates · April 1, 2026 to April 30, 2026
JT-CR-184 · Heart and vascular care
Series
Tearing Chest Pain With Unequal Pulses
An acute aortic syndrome case on probability, CTA, impulse control, branch ischemia, and immediate surgical pathways.
JT-CR-185 · Musculoskeletal, sports, and rehabilitation
Series
An Incidental Positive ANA Without Systemic Features
A pretest-probability case on ANA false positives, symptom-led testing, reflex panels, and avoiding an unsupported autoimmune label.
JT-CR-186 · Children and adolescent health
Series
Hypertension in an Adolescent With Obesity
A pediatric blood-pressure case on accurate measurement, ambulatory confirmation, obesity, kidney and endocrine causes, and family care.
JT-CR-187 · Aging and palliative care
Series
Hypernatremia in an Older Adult With Limited Water Access
A water-balance case on deficit, impaired access, AVP disorders, osmotic losses, correction, and recurrence prevention.
JT-CR-188 · Cancer, blood, infection, and immunity
Series
A New HIV Diagnosis in Primary Care
A stigma-aware case on diagnostic confirmation, rapid linkage, baseline evaluation, treatment, prevention, and durable retention.
JT-CR-189 · Eye, skin, and digital safety
Series
Painful Monocular Vision Loss in a Young Adult
An optic-neuritis case distinguishing demyelination from ischemic, infectious, retinal, orbital, and pressure emergencies.
JT-CR-190 · Eye, skin, and digital safety
Series
Painful Vulvar Lesions After a New Partnership
A confidential genital-ulcer case on herpes, syphilis, inflammatory dermatoses, trauma, testing windows, and prevention.
JT-CR-191 · Men's health and urology
Series
Nocturnal Hand Numbness and Weak Grip
A localization case separating carpal tunnel syndrome from cervical radiculopathy, polyneuropathy, and urgent motor loss.
JT-CR-192 · Mental, behavioral, and substance-use health
Series
An Adult Requesting an ADHD Diagnosis
A lifespan case on developmental history, impairment, mood, sleep, anxiety, substances, trauma, and safe treatment planning.
JT-CR-193 · Eye, skin, and digital safety
Series
A Painful Ulcer That Worsens After Debridement
A pyoderma-gangrenosum case on pathergy, infection and vasculitis exclusion, biopsy purpose, pain, and coordinated wound care.
JT-CR-194 · Men's health and urology
Series
Driving Concerns With Mild Cognitive Impairment
A mobility-centered case on functional driving risk, vision, medicines, law, reporting, and preserving community access.
JT-CR-195 · Emergency and acute care
Series
Escalating Pain Under a New Cast
An acute-compartment-syndrome case on serial examination, analgesia misconceptions, pressure testing, and emergency decompression.
JT-CR-196 · Diabetes and metabolic health
Series
Hypotension Without Fever in an Immunosuppressed Adult
Recognizes afebrile septic shock, adrenal crisis, hemorrhage, and cardiogenic causes when immunosuppression blunts expected signs.
JT-CR-197 · Heart and vascular care
Series
A Bicuspid Aortic Valve Found Incidentally
Turns an incidental bicuspid valve into a structured assessment of valve function, aortic dimensions, family screening, and surveillance.
JT-CR-198 · Cancer, blood, infection, and immunity
Series
A Positive Stool Screening Test With No Symptoms
Explains why an abnormal stool screening result needs diagnostic colonoscopy, timely navigation, and closure even without symptoms.
JT-CR-199 · Children and adolescent health
Series
Bronchiolitis in an Infant With Increased Work of Breathing
Uses feeding, apnea risk, oxygenation, hydration, and serial respiratory effort to guide supportive bronchiolitis care.
JT-CR-200 · Musculoskeletal, sports, and rehabilitation
Series
Fragility Fracture in Advanced CKD
Separates fracture care, osteoporosis risk, and renal osteodystrophy before choosing bone therapy in advanced chronic kidney disease.
JT-CR-201 · Kidney, electrolytes, and digestive health
Series
Fever and Diarrhea After Travel
Uses itinerary, incubation, severity, malaria testing, cultures, and public health clues to evaluate febrile diarrhea after travel.
JT-CR-202 · Men's health and urology
Series
Recurrent Visual Aura in an Older Adult
Distinguishes stereotyped migraine aura from retinal ischemia, TIA, seizure, and ocular disease when visual episodes begin later in life.
JT-CR-203 · Reproductive and postpartum care
Series
Preconception Review for Chronic-Disease Medicines
Balances disease control, reproductive timing, medicine risk, contraception, monitoring, and shared decisions before pregnancy.
JT-CR-204 · Musculoskeletal, sports, and rehabilitation
Series
An Ankle Inversion Injury With Difficulty Walking
Applies fracture rules, targeted examination, imaging, functional support, and reassessment after an acute inversion injury.
JT-CR-205 · Prevention, rural health, and care systems
Series
Multiple Physical Symptoms After Repeated Negative Tests
Builds a validating, bounded evaluation and functional treatment plan for persistent symptoms without missing new objective disease.
JT-CR-206 · Kidney, electrolytes, and digestive health
Series
Fever and Reduced Urine Output After Kidney Transplant
Prioritizes sepsis, obstruction, rejection, drug toxicity, and graft perfusion when fever accompanies acute allograft dysfunction.
JT-CR-207 · Diabetes and metabolic health
Series
Markedly Elevated Aminotransferases After Strenuous Exercise
Distinguishes muscle release from acute hepatic injury using CK, bilirubin, INR, exposure history, kidney risk, and enzyme trajectory.
JT-CR-208 · Eye, skin, and digital safety
Series
Blisters, Skin Pain, and Mucosal Erosions After a New Medicine
Recognizes Stevens-Johnson syndrome and toxic epidermal necrolysis, stops culprit exposure, and protects skin, eyes, airway, and fluids.
JT-CR-209 · Aging and palliative care
Series
Preventing Delirium Around Major Surgery
Builds a multicomponent perioperative plan around cognition, medicines, mobility, sleep, sensory access, hydration, and family knowledge.
JT-CR-210 · Cancer, blood, infection, and immunity
Series
Sickle-Cell Pain With Fever and Falling Oxygen Saturation
Recognizes evolving acute chest syndrome during a pain episode and coordinates analgesia, oxygenation, infection treatment, spirometry, and transfusion.
JT-CR-211 · Heart and vascular care
Series
Progressive Dyspnea With Signs of Pulmonary Hypertension
Moves from echocardiographic probability to etiologic classification and right heart catheterization before pulmonary vascular therapy.
JT-CR-212 · Medicines and care safety
Series
A Copied-Forward Diagnosis That No Longer Fits
Repairs an inherited diagnosis by tracing provenance, comparing current evidence, correcting downstream records, and preserving uncertainty.