Diagnostic Snapshot

Guess What Is in My Brain

Catherine Joseph, MSN, APN, AGACNP-BC

Magnetic resonance imaging (MRI) of the brain is an important diagnostic tool used by neurologists. This article explores the workup and management for a patient with a brain lesion and highlights the importance of neuroimaging. Similari...

Knowing Your Target: Altered Mental Status From an Unsuspected Source

Sarah Hemstetter, MSN, CRNP, AOCNP®

Daratumumab is a human monoclonal antibody targeting CD38 that is used in the treatment of multiple myeloma. In addition to being a target for cancer-related treatment, CD38 also plays a significant role in the immune response to infecti...

Can You Establish the Cause of This Patient’s Shortness of Breath?

Allison Trail, PA-C, Jane Rogers, PharmD, BCOP, and Jaffer Ajani, MD

Mr. B is a 56-year-old man diagnosed with metastatic HER2-positive gastroesophageal adenocarcinoma. He received front-line leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) and trastuzumab for 10 months before restaging imaging reveal...

Heart Failure in a Patient With Metastatic Well-Differentiated Neuroendocrine Tumor

Amy Henderson, ANP-BC, AOCNP®, and Salwan Al Mutar, MD

Patients with neuroendocrine malignancy with liver metastases are at risk for carcinoid heart disease which, if left unchecked, can lead to heart failure. This case study demonstrates a clinical situation in which an advanced practitione...

Convergence of Hematology and Rheumatology: A Case Study

Mariangel Prieto, MSN, APRN, FNP-BC, AOCNP®

Advanced practitioners may frequently encounter patients who have a hematologic and rheumatologic diagnosis. These patients are usually managed by multiple specialists, including hematologists, rheumatologists, and dermatologists, given ...

Indeterminate Thyroid Nodules: When to Worry?

Amanda Tibbels, MPAS, PA-C

Indeterminate thyroid nodules can present a confounding scenario for both provider and patient. Once a diagnosis of an indeterminate thyroid nodule is made, appropriate management can range from conservative observation to surgical resec...

What Is Happening to This Patient With a Rare Leukemia?

Amandine Ndje, MS, MBA, APRN, FNP-C, and Jacqueline B. Broadway-Duren, PhD, DNP, APRN, FNP-BC

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare cancer with primary sites in the skin and bone marrow and secondary sites in the lymph nodes, spleen, and central nervous system. First described in the 1990s, these cells ex...

Lower Extremity Edema: More Than Just the Routine Workup

Alexis Brimm Akins, MSN, CRNP, FNP-C

Establishing a differential diagnosis for symptomatic oncology patients can be complex. The challenges for advanced practitioners in diagnosing acute symptoms in this patient population lie in the reality that symptoms exhibited can mimi...

Mysterious Arm Swelling in a Patient With Non-Hodgkin Lymphoma Complicated by Superior Vena Cava Syndrome

Jessica S. Jang, RN, MSN, ACNP-BC, and Jeffrey S. Jang, BS

Hematologic malignancies often create difficult venous complications. Specifically, with lymphoma, the risk of venous thromboembolism (VTE) is high, often requiring highly specialized accuracy in balancing this coagulopathy. This case st...

Persistent Fever While on Broad-Spectrum Antibiotics in a Patient With Squamous Cell Carcinoma

Xin Li, CRNP, AOCNP®

For solid tumor patients, acute infectious process is often underestimated, especially when caused by fungal, viral, or other atypical pathogens. Providers should perform a comprehensive infectious workup to rule out uncommon pathogen-in...

What Is the Cause of This Biliary Stricture?

Caeli Barker, PA-C

This article describes the presentation and workup of a 63-year-old male with a bile duct stricture, followed by a discussion on management.

Is This Patient’s Liver Mass Cancer?

Dietrich Davis, FNP-BC, and Steven H. Wei, MS, MPH, PA-C, DFAAPA

Undiagnosed liver lesions are important findings that can affect the physical and mental well-being of patients. They are usually incidental findings identified while clinicians are performing other imaging tests. It is important for cli...

Can You Diagnose the Cause of This Patient’s Diarrhea?

Allison Trail, PA-C

This article will review the case of a 53-year-old female with a diagnosis of metastatic esophageal cancer receiving treatment on a clinical trial protocol combining chemotherapy/immunotherapy with FOLFOX and nivolumab, who presents to t...

Atypical Radiculopathy in an Oncology Patient

Mark Davis, PA-C

Practitioners face significant challenges when evaluating patients with cancer who suffer from back pain. Back pain is one of the most common reasons for patients to visit medical providers. This case study will review a patient with can...

Management of Gastric Outlet Obstruction in a Patient With Gastric Cancer

Irene Thomas Thayil, PA-C

This article describes the evaluation of a patient with gastric cancer that confirms gastric outlet obstruction, followed by a discussion on management. 

Diagnostic Snapshot: What Caused This Left Renal Infiltrate in a Young, Healthy Woman?

Elizabeth Wolf, PA-C

Diagnostic Snapshot: A Patient With Gastrointestinal Symptoms and Eosinophilia

Rashida Taher, MPH, PA-C, and Sandra E. Kurtin, PhD, ANP-C, AOCN®

Eosinophila has a number of possible causes and associated disorders; it requires selective testing directed at clinically suspected causes. Read through the history and physical examination, and put your skills to work to determine the ...

Diagnostic Snapshot: Painful Nodules and Recurrent Fever in a Patient With Acute Lymphoblastic Leukemia

Alexis C. Geppner, MLS(ASCP), PA-C

Diagnostic Snapshot: Acute Edema in the Oncology Patient

Alexandra Trudeau, BSN, BS, RN, CNOR, Danielle Bean, BSN, RN, Donna Fleming, MSN, RN, FNP-C, Glaiza Boado, BSN, RN, Natalia Samuels, MSN, RN, and Reshmi Kurup, BS, RN

Diagnostic Snapshot: What Caused This Fluid?

Courtney Robb, RN, MS, CRNFA, FNP-C

Obstructive Dysphagia and Positional Dyspnea: Can You Identify the Cause?

Diagnostic Snapshot: "I Have a Bad Cold"

Tender Nodules of the Foot

Swelling and Erythema of the Lower Extremities

How Do You Triage Abdominal Pain in a Patient With Ovarian Cancer?

Diagnostic Snapshot: Aggressive Malignancy or Benign Lesion?

Can you Identify This Malignancy?

What is the Etiology of Dysarthria and Ataxia in a Woman With Cancer?

Hyperpigmentation of the Tongue

Can You Determine the Cause of This Patient’s Vision Changes?

Mrs. G. is a post–stem cell transplant patient who was admitted to the hospital with a presumed lower GI bleed in the setting of chronic thrombocytopenia and graft-vs.-host disease. On hospital day 21, she has a mild headache, fever, inc...

Can You Determine the Cause of This Patient’s Skin Changes?

Can You Identify This Lesion Seen in a Patient With Melanoma?

Back Pain in a Patient With Lung Cancer

What is the Cause of This Patient’s Symptoms?

Diagnostic Snapshot: Dyspnea in the Oncology Patient

Diagnostic Snapshot: Can You Identify This Skin Rash?