JT-CR-244 · Cancer, blood, infection, and immunity
Series
Redness and Drainage Over a Cardiac Device Pocket
A device-pocket infection analysis covering bacteremia, echocardiography, extraction planning, pacing dependence, and safe reimplantation.
Daily clinical reasoning series
June 2026
30 case-based clinical reasoning analyses assigned to the daily casebook sequence for June 2026.
Case-series dates · June 1, 2026 to June 30, 2026
JT-CR-245 · Cancer, blood, infection, and immunity
Series
Persistent Night Sweats Without a Clear Diagnosis
A calibrated workup for persistent drenching night sweats using tempo, exposures, examination, targeted tests, and scheduled reassessment.
JT-CR-246 · Children and adolescent health
Series
Recurrent Infections in a Child
A longitudinal analysis of recurrent childhood infections using verified episodes, growth, immune screening, anatomy, and family history.
JT-CR-247 · Diabetes and metabolic health
Series
A Newly Discovered Thyroid Nodule
Risk-stratified thyroid nodule reasoning using TSH, ultrasound patterns, lymph-node assessment, selective biopsy, and surveillance.
JT-CR-248 · Brain and neurologic health
Series
Fever, Headache, and Low Platelets After a Tick Bite
Time-sensitive tick-borne illness reasoning using exposure, cytopenias, transaminases, PCR timing, and treatment without delay.
JT-CR-249 · Men's health and urology
Series
Painful Wrist Drop With Systemic Symptoms
Localization of painful wrist drop with systemic findings, separating compression from vasculitic mononeuritis multiplex and organ threat.
JT-CR-250 · Reproductive and postpartum care
Series
Severe Vomiting and Ketosis in Pregnancy
Management reasoning for severe pregnancy vomiting with ketosis, acid-base disturbance, dehydration, and competing euglycemic ketoacidosis.
JT-CR-251 · Musculoskeletal, sports, and rehabilitation
Series
Knee Locking After a Twisting Injury
Recognition of a truly locked knee after rotation, with meniscal displacement, fracture exclusion, imaging, and timely orthopedic review.
JT-CR-252 · Mental, behavioral, and substance-use health
Series
Depression Presenting as Cognitive Change in Later Life
Longitudinal reasoning for late-life depression with cognitive complaints, safety assessment, functional collateral, and reassessment.
JT-CR-253 · Kidney, electrolytes, and digestive health
Series
Hypertension and a Family History of Kidney Cysts
Longitudinal reasoning for possible inherited polycystic kidney disease, including imaging, blood pressure, genetics, and complications.
JT-CR-254 · Kidney, electrolytes, and digestive health
Series
Acute Hepatitis With Very High Aminotransferases
Recognition of severe acute hepatocellular injury using encephalopathy, coagulation, exposure timing, viral testing, and transfer thresholds.
JT-CR-255 · Children and adolescent health
Series
Patchy Hair Loss and Scalp Scale in a Child
A child-scalp analysis distinguishing tinea capitis from alopecia areata, traction, hair pulling, and inflammatory dermatoses.
JT-CR-256 · Aging and palliative care
Series
Recurrent Hospitalization and Caregiver Exhaustion
A systems analysis of repeated admissions that integrates acute illness, medication reconciliation, caregiver capacity, and transition reliability.
JT-CR-257 · Cancer, blood, infection, and immunity
Series
Marked Leukocytosis After Steroid Treatment
Interpretation of marked neutrophilic leukocytosis after glucocorticoids while preserving detection of infection and marrow disease.
JT-CR-258 · Cancer, blood, infection, and immunity
Series
Bronchiectasis Exacerbation in an Adult With Cystic Fibrosis
Management reasoning for a cystic-fibrosis pulmonary exacerbation using prior cultures, severity, airway clearance, and recovery targets.
JT-CR-259 · Eye, skin, and digital safety
Series
An Oxygen-Saturation Algorithm That Performs Differently Across Skin Tones
A systems-safety analysis of pulse-oximetry bias using paired validation, subgroup performance, escalation rules, and governance.
JT-CR-260 · Kidney, electrolytes, and digestive health
Series
Delayed Vomiting and Liver Injury After Wild-Mushroom Ingestion
Recognition of delayed amatoxin poisoning using exposure reconstruction, symptom-free interval, serial liver tests, antidotal care, and transfer.
JT-CR-261 · Heart and vascular care
Series
Myocardial Infarction With No Obstructive Coronary Lesion
A MINOCA working-diagnosis analysis using angiographic review, cardiac MRI, intracoronary imaging, and cause-directed prevention.
JT-CR-262 · Cancer, blood, infection, and immunity
Series
Post-Infectious Fatigue With Post-Exertional Worsening
Longitudinal reasoning for post-infectious fatigue with post-exertional symptom worsening, orthostatic features, and pacing.
JT-CR-263 · Children and adolescent health
Series
Irregular Menses in an Adolescent
A confidential adolescent evaluation of irregular cycles using pregnancy testing, pubertal timing, androgen signs, nutrition, and follow-up.
JT-CR-264 · Diabetes and metabolic health
Series
Polyuria and Hypernatremia After Pituitary Surgery
Postoperative polyuria reasoning using paired serum and urine data, desmopressin response, free-water access, and phase changes.
JT-CR-265 · Cancer, blood, infection, and immunity
Series
A Positive TB Test Before Biologic Therapy
A pre-biologic tuberculosis pathway separating latent infection from active disease, then coordinating treatment, interactions, and timing.
JT-CR-266 · Men's health and urology
Series
Electric-Shock Facial Pain
Localization and risk assessment for brief triggered facial pain, separating classical trigeminal neuralgia from secondary and dental causes.
JT-CR-267 · Reproductive and postpartum care
Series
Painful Contractions Before Term
Management reasoning for possible preterm labor using gestational age, cervical change, membrane status, fetal condition, and transfer.
JT-CR-268 · Musculoskeletal, sports, and rehabilitation
Series
Elbow Pain and Hand Numbness at Work
Occupational reasoning for ulnar-distribution numbness using localization, ergonomic exposure, electrodiagnostics, and weakness follow-up.
JT-CR-269 · Men's health and urology
Series
Confusion and Gait Instability With Heavy Alcohol Use
Recognition of possible Wernicke encephalopathy using clinical findings, immediate thiamine, magnesium, and parallel evaluation.
JT-CR-270 · Musculoskeletal, sports, and rehabilitation
Series
Dark Urine and Kidney Injury After Extreme Exercise
Management of exertional rhabdomyolysis using potassium, kidney function, compartment checks, individualized fluids, and recurrence review.
JT-CR-271 · Kidney, electrolytes, and digestive health
Series
Chronic Constipation With New Alarm Features
A constipation analysis that responds to weight loss, anemia, bleeding, obstruction signs, and change from baseline with timely evaluation.
JT-CR-272 · Cancer, blood, infection, and immunity
Series
A Nonhealing Oral Ulcer
Recognition of a persistent indurated oral ulcer requiring prompt tissue diagnosis while comparing trauma, infection, and inflammation.
JT-CR-273 · Aging and palliative care
Series
Secondary Fracture Prevention After Hip Fracture
A post-hip-fracture pathway integrating osteoporosis treatment, secondary causes, falls, rehabilitation, and reliable follow-through.