Top 10 Trending Clinical Challenges from JAMA Network™

Clinical Challenges are an excellent way to test your diagnostic skills while earning CME/MOC credit. Brought to you by JN Learning™, the JAMA Network’s home for CME and MOC, these online learning opportunities present an actual patient case with a specific disease or condition alongside a clinical image. Participants are tasked with making the diagnosis and ordering the next best test or treatment, with the chance to earn AMA PRA Category 1 CME Credit™.

The top 10 trending Clinical Challenges of 2021 to date, span a range of specialties—from dermatology to cardiology to gastroenterology. Each presents a unique opportunity to test your knowledge and clinical acumen. Here they are, in descending order:

1. Dysphagia in a 34-Year-Old Woman

   
   

   A 34-year-old woman presented with two years of progressively worsening intermittent dysphagia, primarily to solids, especially meats, localized retrosternally. She reported no heartburn, nausea, vomiting, abdominal pain, weight loss or changes in bowel habits. Read more and take the quiz.

2. Scaly Dermatitis and Edema in an Irritable Child

   
   

   A 19-month-old boy presented for evaluation of widespread edema and acute dermatitis. Following an upper respiratory tract infection one month prior, he developed disseminated red, scaly patches and a progressive eruption of hyperpigmented and hypopigmented patches of skin. Read more and take the quiz.

3. Asymptomatic Purpuric Eruption on the Scalp of a Middle-aged Man

   
   

   A man in his sixties presented to the clinic with a several-day history of non-tender, non-itchy purpuric rash on his scalp. The patient denied using any over-the-counter or prescription topicals at the affected sites before the onset of the eruption, except for petroleum jelly. Read more and take the quiz.

4. A 22-Year-Old Man With Painful Vesicles on His Flank

   
   

   A 22-year-old man presented with an eight-year history of painful and slightly pruritic skin lesions on his right flank. The number of lesions and degree of pain had alternately increased and decreased over the years. Read more and take the quiz.

5. A Man With Incessant Narrow Complex Tachycardia

   
   

   A 30-year-old man presented to the emergency department with palpitations and tachycardia. He had been experiencing sore throat, fevers, and myalgias for the past day. Read more and take the quiz.

6. A Man With Headache, Fever, and Neck Stiffness

   
   

   A 53-year-old man presented with two weeks of back pain, stiff neck, headache and fevers. He also reported three days of right knee pain and swelling. Read more and take the quiz.

7. An 18-Month History of Dorsal Foot Lesions

   
   

   A 32-year-old Nigerian woman presented with dull pain, pruritus and discoloration of the dorsal aspect of both feet for 18 months. Her medical history included a red blood cell transfusion as a child and two uncomplicated pregnancies. Read more and take the quiz.

8. Pruritic Rash and Diarrhea

   
   

   An 82-year-old woman presented to the emergency department with two months of diarrhea and two weeks of rash. She had sustained a left radius fracture six months prior, which resulted in deconditioning and poor appetite. Read more and take the quiz.

9. Recurrent Hematochezia in a Returning Traveler

   
   

   A 28-year-old man presented to his primary care physician for hematochezia. He had previously lived for a few years in Uganda and frequently swam in the Nile River. After returning to the U.S., he experienced recurrent diarrhea. Read more and take the quiz.

10. A Purpuric Rash

    
    

    A 48-year-old man with a history of gastroesophageal reflux disease and obstructive sleep apnea presented with a rash over his right foot accompanied by one week of episodic fever, diaphoresis and headaches. Read more and take the quiz.

Looking for more Clinical Challenges? Find them here.