Where medicinethinks together.

A 35-year-old G2P1 at 34 weeks with major placenta previa presents with painless bright red vaginal bleeding of approximately 300 mL. Previous C-section scar raises concern for pla…

A 25-year-old woman with 6 weeks LMP presents with lower abdominal pain and spotting. Urine hCG positive, TVS shows a right adnexal mass of 2.8 cm with a yolk sac, no intrauterine …

A 28-year-old woman with PCOS (Rotterdam criteria) has been trying to conceive for 18 months. She has oligomenorrhea, AMH of 8 ng/mL, and BMI of 28. What is the first-line ovulatio…

A G3P3 patient has estimated blood loss of 1200 mL after vaginal delivery with uterine atony. After IV oxytocin 20 units, uterus remains boggy. What is the stepwise approach: misop…

A 32-year-old woman diagnosed with GDM at 26 weeks has fasting glucose 105-115 mg/dL despite 2 weeks of dietary modification and moderate exercise. What are the target glucose leve…

During a vaginal delivery of a macrosomic baby (estimated 4.5 kg), the head delivers but the shoulders are impacted at the symphysis. After calling for help, what is the correct se…

A 26-year-old G1P0 at 28 weeks presents with regular uterine contractions every 5 minutes, cervical dilation of 2 cm, and intact membranes. How long can we safely tocolyze with nif…

A 30-year-old primigravida at 33 weeks gestation presents with BP 168/110 mmHg, severe headache, epigastric pain, and 3+ proteinuria. Labs show elevated LFTs and platelets of 89,00…

A 74-year-old hypertensive male presents with a 2-year history of progressive cognitive decline. His deficits began abruptly after a lacunar infarct and have progressed in a stepwi…

A 35-year-old female with chronic migraine (> 15 headache days/month) has failed topiramate and amitriptyline due to side effects. She is now on overusing triptans. What is the cur…

A 58-year-old diabetic male presents with bilateral symmetric distal numbness, burning pain, and mild weakness of foot dorsiflexion. EMG/NCS shows predominantly axonal sensorimotor…

A 55-year-old woman with aneurysmal SAH (Hunt-Hess grade 3, Fisher grade 3) had successful coil embolization on day 1. On day 5, she develops new focal deficits and TCD shows eleva…

A 62-year-old man with newly diagnosed Parkinson's disease presents with mild resting tremor, rigidity, and bradykinesia but is still functionally independent. He asks whether star…

A 30-year-old male presents with ascending weakness starting in the legs, areflexia, and mild respiratory compromise 2 weeks after a campylobacter gastroenteritis. NCS confirms AID…

A 42-year-old woman presents to the ED with a sudden severe headache she describes as the worst of her life, with onset during exercise. No fever, no neck stiffness initially. How …