Where medicinethinks together.

A 48-year-old obese male (BMI 35) presents with excessive daytime somnolence, witnessed apneas, and morning headaches. Epworth Sleepiness Scale score is 18. Polysomnography shows A…

A 50-year-old male smoker (25 cigarettes/day for 30 years) wants to quit. He has mild depression and is currently on sertraline. He has tried NRT patches twice without success. How…

A 58-year-old male smoker presents with 3 episodes of hemoptysis, each ~30 mL, over the past week. He has a 40 pack-year history and prior TB treated 15 years ago. Vitals stable. C…

A 40-year-old patient with sepsis-induced ARDS has PaO2/FiO2 ratio of 95 on 60% FiO2. They are on volume-controlled ventilation. What are the current evidence-based recommendations…

A 22-year-old female track runner presents with recurrent episodes of inspiratory stridor, throat tightness, and dyspnea during intense exercise. Spirometry is normal between episo…

A 62-year-old patient with advanced lung adenocarcinoma develops a recurrent large right pleural effusion causing significant dyspnea. After two thoracenteses, the effusion rapidly…

What are the current GOLD guidelines criteria for prescribing LTOT in stable COPD? Specifically, what PaO2 and SpO2 thresholds trigger initiation, how many hours/day should it be u…

A 55-year-old non-smoker presents with progressive dyspnea and dry cough over 6 months. PFTs show a restrictive pattern with reduced DLCO. CXR shows bilateral basal haziness. At wh…

Patient is a 45-year-old female presenting with sudden onset pleuritic chest pain, tachycardia, and mild hypoxia. She recently returned from a long-haul flight. CXR is essentially …

A 68-year-old male with known COPD (GOLD stage III) presents with worsening dyspnea, increased sputum production, and SpO2 of 82% on room air. He is tachypneic with RR 28/min and u…