A 22-year-old man presented to the hospital with fever for 4 days. He also complained of myalgia and sore throat. His blood pressure was 110/70 mmHg, pulse rate 90/min, respiratory rate 20/min, and body temperature 39.2 ℃. Multiple cervical lymph nodes were palpable bilaterally and were tender to touch. The lesions were as shown in Figure A. The blood test results were as follows. What is the appropriate treatment?

A 61-year-old man presents to the emergency department with chest pain that began 3 days ago. He has a history of coronary stent implantation 20 years ago, but discontinued his medications 8 months ago. Three days ago, he was evaluated at another hospital for chest pain and advised to undergo treatment, but he left against medical advice. On arrival today, ECG demonstrates ST-elevation myocardial infarction (STEMI). He undergoes coronary angiography (Video A) followed by stent implantation. On the following day, transthoracic echocardiography demonstrates the findings shown in Video B. Which of the following medications should be added to this patient’s regimen?

A 64-year-old female presents with a 2-week history of generalized swelling. On examination, she has grade 4 pitting edema in both lower extremities. She is admitted to the hospital, and the following laboratory results are obtained:

Two months ago, her serum creatinine was 0.6 mg/dL. After admission, her daily urine output decreased to approximately 300 mL. Bilateral pleural effusions gradually developed, and she did not respond to diuretic therapy, so hemodialysis was initiated. A kidney biopsy was performed (see Figures). Serologic testing revealed MPO antibody >134 IU/mL, with no other significant findings. Which of the following is the most appropriate treatment?

A 29-year-old woman diagnosed with ulcerative colitis two months earlier was admitted with 9?10 episodes of diarrhea per day accompanied by hematochezia. Despite intravenous corticosteroids and oral 5-ASA therapy, symptoms persisted, and infliximab and azathioprine were initiated. On day 5 after treatment escalation, she developed severe abdominal distension and pain. Abdominal radiography showed the findings in Fig. 2. What is the most appropriate treatment?

A 54-year-old man presents with several years of persistent low-back pain and morning stiffness. What is the most appropriate diagnosis?

A 54-year-old man presented with fever and back pain. The pain had acutely worsened the day before, to the point where he could no longer stand up. He reported experiencing occasional back pain in the past and had undergone acupuncture multiple times. His vital signs were: blood pressure 100/70 mmHg, heart rate 120 beats per minute, respiratory rate 20 breaths per minute, and body temperature 38.9℃. Lumbar spine MRI is shown (Figure A). Considering the Gram stain findings from a blood sample (Figure B), which antibiotic would be appropriate?

A 75-year-old woman is hospitalized for recurrent syncopal episodes. She has a history of breast cancer and is currently undergoing chemotherapy. Since starting chemotherapy, she has developed severe nausea and vomiting and has been taking the antiemetic ondansetron. On admission, her initial 12-lead ECG is shown in Figure A. During hospitalization, she again experiences a brief loss of consciousness lasting about 10 seconds. At that time, the bedside monitor demonstrates the rhythm shown in Figure B. Which of the following is the most likely diagnosis and the appropriate management?

A 78-year-old man presented with persistent abnormal findings on abdominal CT performed three months after treatment for abdominal pain at another hospital. He had no abdominal pain, fever, nausea, or vomiting at presentation. Physical examination was unremarkable. Based on the CT findings, what is the most appropriate management?

A 58-year-old man presented with recurrent angioedema and dyspnea following consumption of pork or beef. Until three years ago, he had never experienced adverse reactions after meals. Beginning two years ago, when he consumed beef, pork, or goat meat, urticaria appeared approximately 3-4 hours later, followed rapidly by angioedema, dyspnea, nausea, and vomiting. One month ago, he presented to the emergency department four hours after eating pork with angioedema, dyspnea, and dizziness, and was diagnosed with anaphylaxis associated with hypotension. He resides in a rural area and engages in hillside farming as a weekend hobby. Three years ago, he sustained an insect bite on his leg-presumably from a tick-resulting in a rash and small nodular scarring. He reports no symptoms following consumption of other foods; duck and chicken cause no adverse reactions. What is the most likely diagnosis?

A 27-year-old man presented to the hospital with a painful, indurated swelling on the occipital scalp that began a week ago. This morning, purulent discharge began oozing from the area. He reported a habitual tendency to scratch his scalp due to frequent itching. He had been taking an antibiotic prescribed by a nearby clinic for the past four days, which was identified as cephradine (a first-generation cephalosporin). Which empirical antibiotic would be most appropriate to use before the culture results become available?

An 84-year-old woman with a history of hypertension, diabetes mellitus, and atrial fibrillation presents after a syncopal episode. Serial ECGs demonstrate variable findings (Figures A and B). A 24-hour Holter monitor subsequently reveals a 7-second episode of asystole (Figure C). For treatment, the procedure shown in Figure D was performed. Which of the following statements is correct?

A 52-year-old woman with a history of pulmonary tuberculosis began combination therapy with isoniazid (INH), rifampin (RFP), pyrazinamide (PZA), and ethambutol (EMB) one month prior. Three days before presentation, she developed a fever over 38°C accompanied by tonsillar swelling. Believing it to be a common cold, she self-administered antipyretics as needed for fever. One day before admission, she noticed a worsening, generalized pruritic erythematous rash. Her pruritus intensified, and she developed facial edema, leading her to seek emergency care. On examination, she was found to have bilateral cervical lymphadenopathy. Chest imaging, laboratory evaluation, and detailed assessment of the rash were performed.

What is the most likely diagnosis?

A 45-year-old female patient presented with a 3-day history of headache and fever. She had no significant past medical history. After being diagnosed with pelvic inflammatory disease, she was treated with ceftriaxone, metronidazole, and doxycycline. Although her fever and infection improved, she suddenly developed oliguria (decreased urine output) on the 12th day of antibiotic therapy and was referred to the nephrology department. Laboratory tests and urinalysis were performed, and a kidney biopsy was obtained to determine the cause. Among the following statements regarding this condition, which one does not accurately represent an appropriate explanation or treatment?

A 54-year-old woman presented with epigastric discomfort. She had no significant past medical history and did not smoke or consume alcohol. Physical examination and laboratory tests were unremarkable. Upper gastrointestinal endoscopy revealed the findings shown in Fig. 1, and CLO test and biopsy findings are shown in Figs. 2 and 3. What is the most appropriate next diagnostic test or treatment?

A 61-year-old man with alcoholic liver cirrhosis was incidentally found to have the following lesion on endoscopy (A). Abdominal CT demonstrated a shunt between the lesion and the renal vein (B, red circle). As the patient was residing in the Philippines with limited access to medical care, prophylactic treatment was performed prior to departure (C). What treatment did the patient receive?

A 57-year-old female has felt fatigued for 3 months and noticed lower-extremity swelling for the past week. Laboratory studies and a kidney biopsy (Figures 1 and 2) are shown. What is the most appropriate treatment?

A 74-year-old woman is admitted to the intensive care unit for management of septic shock secondary to pneumonia. An emergency call is triggered due to the ECG findings shown in Figure A. The on-call resident attempts defibrillation with biphasic 150 J, but an abnormal ECG tracing persists as shown in Figure B.
What is the most appropriate diagnosis and next step in management?

An 82-year-old man who had been receiving treatment for heart failure and was preparing for discharge suddenly developed fever and pain in both knees. His temperature was 39 °C, blood pressure 110/80 mmHg, and pulse rate 97/min; the electrocardiogram was unchanged from previous tracings. Both knees were swollen and tender. The results of blood and synovial-fluid tests (Figure A) and radiographs of both knees (Figure B) are as follows. What is the treatment?

A 66-year-old man presented with melena that began on the day of admission. His vital signs were stable, and the hemoglobin level was 7.8 g/dL. Upper and lower gastrointestinal endoscopy failed to identify the source of bleeding. Abdominal computed tomography (CT) (A) and double-balloon enteroscopy (B) revealed a tumor in the small intestine, and surgical resection was performed. Based on the histopathologic findings (C), what is the most likely diagnosis?

A 34-year-old woman presents with exertional dyspnea that has developed over the past month. She had been previously healthy, with no significant past medical history. Her blood pressure is 120/60 mmHg, heart rate is 77 beats per minute, and body temperature is 36.7°C. On physical examination, a continuous murmur with an associated palpable thrill was auscultated along the left sternal border. Transthoracic echocardiography demonstrates the following findings (Figures A, B, C).
What is the most likely diagnosis?

A 20-year-old man presented to the hospital with fever as his chief complaint. He had recently returned from a trip to Laos two weeks prior. On physical examination, a skin rash was noted (Figure A), and laboratory results are shown in Figure B. What is the appropriate treatment?

A 29-year-old man was referred to the hospital after proteinuria was incidentally discovered during a routine health examination. He reported a history of anhidrosis and occasional burning pain in his hands and feet. Past medical history was otherwise unremarkable. Physical examination revealed absent axillary hair, along with spotted lesions on the buttocks and chest. His mother had a history of hypertension, heart failure, and ventricular tachycardia (requiring pacemaker placement), as well as a cerebrovascular event at age 40. Current vital signs included a blood pressure of 130/80 mmHg, heart rate of 65 beats/min, and respiratory rate of 20 breaths/min. The following are his lab results (A) and kidney biopsy findings (B):

A 57-year-old male was found to have an incidental renal cyst during a routine health examination. An abdominal CT scan was performed (Figures A and B). Which of the following is the most appropriate next step in management?