[{"id":"BENCH-009","title":"A Patient with Acute Inferior Myocardial Infarction and Ventricular Septal Rupture","year":"2015","ground_truth":"Acute inferior myocardial infarction with ventricular septal rupture","our_diagnosis":"Acute Inferior STEMI with Right Ventricular Infarction causing Cardiogenic Shock","score":3,"correct":false},{"id":"case_2015_30","title":"Case 30-2015 \u2014 A 50-Year-Old Man with Cardiogenic Shock","year":"2015","ground_truth":"Myotonic dystrophy type 1, with associated cardiomyopathy, cardiac arrest, and generalized ischemia.","our_diagnosis":"Myotonic dystrophy type 1 (DM1, Steinert disease) \u2014 chronic unifying diagnosis","score":5,"correct":true},{"id":"case_2015_31","title":"Case 31-2015 \u2014 A 29-Year-Old Man with Thymoma, Diarrhea, and Weight Loss","year":"2015","ground_truth":"Thymoma (types B2 and B3, clinical stage 4A), with associated cellular and humoral immunodeficiency (Good's syndrome), autoimmune enteropathy, and pure red-cell aplasia.","our_diagnosis":"PI3K-isoform (likely \u03b4) inhibitor\u2013induced immune-mediated enterocolitis (iatrogenic GVHD-like toxicity from Treg depletion)","score":4,"correct":true},{"id":"case_2015_32","title":"Case 32-2015 \u2014 A 57-Year-Old Man with Severe Pneumonia and Hypoxemic Respiratory Failure","year":"2015","ground_truth":"Disseminated pulmonary blastomycosis involving the hilar lymph nodes and spleen, early hepatic cirrhosis, and acute tubular necrosis.","our_diagnosis":"Pulmonary blastomycosis with ARDS (Blastomyces dermatitidis)","score":5,"correct":true},{"id":"case_2015_33","title":"Case 33-2015 \u2014 A 57-Year-Old Woman with Hair Loss and Deepening Voice","year":"2015","ground_truth":"Ovarian hyperthecosis.","our_diagnosis":"Ovarian stromal hyperthecosis on a background of lifelong PCOS (postmenopausal unmasking)","score":5,"correct":true},{"id":"case_2015_34","title":"Case 34-2015 \u2014 A 36-Year-Old Woman with a Lung Mass, Pleural Effusion, and Hip Pain","year":"2015","ground_truth":"IgG4-related pulmonary disease.","our_diagnosis":"Erdheim\u2013Chester disease (non-Langerhans histiocytosis)","score":4,"correct":true},{"id":"case_2015_35","title":"Case 35-2015 \u2014 A 72-Year-Old Woman with Proteinuria and a Kidney Mass","year":"2015","ground_truth":"PLA2R-type membranous nephropathy.\n\nClear-cell renal-cell carcinoma.","our_diagnosis":"Clear cell renal cell carcinoma (ccRCC) with concurrent diabetic glomerulosclerosis (two-diagnosis unifier)","score":5,"correct":true},{"id":"case_2015_36","title":"Case 36-2015 \u2014 A 27-Year-Old Woman with a Lesion of the Ear Canal","year":"2015","ground_truth":"Epithelioid hemangioma.","our_diagnosis":"Angiolymphoid Hyperplasia with Eosinophilia (ALHE) / Epithelioid Hemangioma of the EAC (with background pruritic dermatitis/contact sensitization explaining bilateral pruritus)","score":5,"correct":true},{"id":"case_2015_37","title":"Case 37-2015 \u2014 A 76-Year-Old Man with Fevers, Leukopenia, and Pulmonary Infiltrates","year":"2015","ground_truth":"Disseminated Mycobacterium bovis infection.","our_diagnosis":"Progressive disseminated histoplasmosis (Histoplasma capsulatum)","score":4,"correct":true},{"id":"case_2015_38","title":"Case 38-2015 \u2014 A 21-Year-Old Man with Fatigue and Weight Loss","year":"2015","ground_truth":"Metastatic choriocarcinoma involving the liver.\n\nTesticular teratoma with a focus of calcification consistent with a regressed germ-cell tumor.","our_diagnosis":"Metastatic nonseminomatous germ cell tumor (NSGCT), likely mixed with choriocarcinoma component and 'burned-out' testicular primary (right testis)","score":5,"correct":true},{"id":"case_2015_39","title":"Case 39-2015 \u2014 A 22-Year-Old Man with Hypoxemia and Shock","year":"2015","ground_truth":"Influenza A virus.","our_diagnosis":"Post-influenza necrotizing bacterial pneumonia (S. aureus PVL+/MRSA or Group A Streptococcus) with septic shock and secondary cardiomyopathy","score":4,"correct":true},{"id":"case_2015_40","title":"Case 40-2015 \u2014 A 40-Year-Old Homeless Woman with Headache, Hypertension, and Psychosis","year":"2015","ground_truth":"Schizophrenia, cognitive impairment associated with schizophrenia, hypertension, and homelessness.","our_diagnosis":"Primary psychotic disorder (schizophrenia, chronic) + essential hypertension with hypertensive emergency","score":5,"correct":true},{"id":"case_2015_41","title":"Case 41-2015 \u2014 A 14-Year-Old Boy with Immune and Liver Abnormalities","year":"2015","ground_truth":"Dyskeratosis congenita (a telomere syndrome), with nodular regenerative hyperplasia of the liver, portal hypertension, hypersplenism, and immunodeficiency.","our_diagnosis":"Dyskeratosis congenita / Telomere Biology Disorder (X-linked, DKC1 mutation; possibly Hoyeraal\u2013Hreidarsson variant)","score":5,"correct":true},{"id":"case_2016_01","title":"Case 1-2016 \u2014 An 18-Year-Old Man with Fever, Abdominal Pain, and Thrombocytopenia","year":"2016","ground_truth":"Hemophagocytic lymphohistiocytosis of an unknown cause.","our_diagnosis":"Tularemia (Francisella tularensis) \u2014 typhoidal or glandular form, possibly with epididymal portal of entry","score":3,"correct":false},{"id":"case_2016_02","title":"Case 2-2016 \u2014 An 84-Year-Old Woman with Chest Pain, Dyspnea, and a Rash","year":"2016","ground_truth":"Systemic amyloidosis.","our_diagnosis":"Systemic AL (immunoglobulin light-chain) amyloidosis with cardiac and cutaneous involvement","score":5,"correct":true},{"id":"case_2016_03","title":"Case 3-2016 \u2014 A 9-Year-Old Girl with Intermittent Abdominal Pain","year":"2016","ground_truth":"Chronic recurrent abdominal pain caused by intermittent torsion of an accessory spleen.","our_diagnosis":"Intestinal malrotation with intermittent (partial) midgut volvulus or Ladd-band compression","score":3,"correct":false},{"id":"case_2016_04","title":"Case 4-2016 \u2014 A 58-Year-Old Woman with a Skin Ulcer, Fever, and Lymphadenopathy","year":"2016","ground_truth":"Ulceroglandular tularemia.","our_diagnosis":"Ulceroglandular tularemia (Francisella tularensis)","score":5,"correct":true},{"id":"case_2016_05","title":"Case 5-2016 \u2014 A 43-Year-Old Man with Altered Mental Status and a History of Alcohol Use","year":"2016","ground_truth":"Cerebral mucormycosis","our_diagnosis":"Primary CNS lymphoma (diffuse large B-cell type), non-HIV type \u2014 explaining the intraventricular mass","score":4,"correct":true},{"id":"case_2016_06","title":"Case 6-2016 \u2014 A 10-Year-Old Boy with Abdominal Cramping and Fevers","year":"2016","ground_truth":"The constitutional mismatch-repair deficiency syndrome and stage III adenocarcinoma of the colon.","our_diagnosis":"Very-early-onset IBD (Crohn's colitis) \u2014 including possible monogenic IBD","score":4,"correct":true},{"id":"case_2016_07","title":"Case 7-2016 \u2014 An 80-Year-Old Man with Weight Loss, Abdominal Pain, Diarrhea, and an Ileocecal Mass","year":"2016","ground_truth":"Tuberculous enteritis.","our_diagnosis":"Gastrointestinal (ileocecal) tuberculosis with pulmonary TB, now accelerated by iatrogenic budesonide immunosuppression","score":5,"correct":true},{"id":"case_2016_08","title":"Case 8-2016 \u2014 A 71-Year-Old Man with Recurrent Fevers, Hypoxemia, and Lung Infiltrates","year":"2016","ground_truth":"Recurrent chronic eosinophilic pneumonia.","our_diagnosis":"Recurrent aspiration pneumonitis/pneumonia due to oropharyngeal dysphagia (chronic aspiration lung disease)","score":4,"correct":true},{"id":"case_2016_09","title":"Case 9-2016 \u2014 A 29-Year-Old Man with Dyspnea and Chest Pain","year":"2016","ground_truth":"Pulmonary embolism and an intracardiac mass due to a metastatic germ-cell tumor.","our_diagnosis":"Right atrial myxoma (probable villous/papillary variant) with tumor embolization to pulmonary artery and pulmonary infarction","score":4,"correct":true},{"id":"case_2016_10","title":"Case 10-2016 \u2014 A 22-Year-Old Man with Sickle Cell Disease, Headache, and Difficulty Speaking","year":"2016","ground_truth":"Multifocal infarction in the territory of the left middle cerebral artery due to artery-to-artery thromboembolism resulting from occlusion of the left internal carotid artery; the infarction was related to sickle cell arteriopathy and resulted in alexia, partial Gerstmann syndrome, and cardiac dysautonomia.\n\nMultiple intracranial aneurysms, related to sickle cell arteriopathy.","our_diagnosis":"Ischemic stroke in the dominant angular gyrus due to sickle cell\u2013associated moyamoya vasculopathy","score":5,"correct":true},{"id":"case_2016_11","title":"Case 11-2016 \u2014 A 12-Year-Old Boy with Malaise, Fevers, Abdominal Pain, and Pallor","year":"2016","ground_truth":"Mixed-cellularity subtype of classic Hodgkin's lymphoma and Epstein\u2013Barr virus infection","our_diagnosis":"Pediatric Crohn disease (inflammatory bowel disease)","score":4,"correct":true},{"id":"case_2016_12","title":"Case 12-2016 \u2014 An 8-Year-Old Boy with an Enlarging Mass in the Right Breast","year":"2016","ground_truth":"Secretory carcinoma of the breast.","our_diagnosis":"Juvenile (pediatric) fibroadenoma of the right breast with coexisting mild peripheral feminization and premature adrenarche","score":4,"correct":true},{"id":"case_2016_13","title":"Case 13-2016 \u2014 A 49-Year-Old Woman with Sudden Hemiplegia and Aphasia during a Transatlantic Flight","year":"2016","ground_truth":"Acute ischemic stroke, caused by paradoxical embolism through a patent foramen ovale, in a patient with the May\u2013Thurner syndrome and a hypercoagulable state due to an occult renal-cell carcinoma.","our_diagnosis":"Paradoxical cerebral embolism via patent foramen ovale (PFO) from thrombus within a congenital slow-flow venous malformation of the left thigh (Klippel\u2013Tr\u00e9naunay spectrum or isolated VM with localized intravascular coagulopathy), possibly with additional prior subclinical paradoxical events","score":5,"correct":true},{"id":"case_2016_14","title":"Case 14-2016 \u2014 A 37-Year-Old Woman with Adult-Onset Psychosis","year":"2016","ground_truth":"Celiac disease in histologic remission.","our_diagnosis":"Celiac disease (gluten-sensitive enteropathy) with neuropsychiatric and endocrine manifestations","score":5,"correct":true},{"id":"case_2016_15","title":"Case 15-2016 \u2014 A 32-Year-Old Man with Olfactory Hallucinations and Paresthesias","year":"2016","ground_truth":"Neurosarcoidosis (focal sarcoid granulomatous encephalitis).","our_diagnosis":"Neurosarcoidosis (possibly isolated CNS or early systemic)","score":5,"correct":true},{"id":"case_2016_16","title":"Case 16-2016 \u2014 A 31-Year-Old Pregnant Woman with Fever","year":"2016","ground_truth":"Listeria monocytogenes bacteremia.","our_diagnosis":"Maternal listeriosis (Listeria monocytogenes bacteremia) with listerial chorioamnionitis","score":5,"correct":true},{"id":"case_2016_17","title":"Case 17-2016 \u2014 A 60-Year-Old Woman with Increasing Dyspnea","year":"2016","ground_truth":"Obliterative bronchiolitis with fibrosis.","our_diagnosis":"Granulomatosis with polyangiitis (GPA), airway-limited / ANCA-negative","score":3,"correct":false},{"id":"case_2016_18","title":"Case 18-2016 \u2014 A 52-Year-Old Woman with a Pleural Effusion","year":"2016","ground_truth":"Ovarian fibroma and pleural effusion consistent with the Demons\u2013Meigs syndrome.","our_diagnosis":"Ovarian fibroma/fibrothecoma causing NEW pseudo-Meigs-like ascites and recent worsening of a PRE-EXISTING (separate-etiology) right pleural effusion","score":5,"correct":true},{"id":"case_2016_19","title":"Case 19-2016 \u2014 A 65-Year-Old Man with End-Stage Renal Disease and a Pruritic Rash","year":"2016","ground_truth":"Adult T-cell leukemia\u2013lymphoma.","our_diagnosis":"Secondary syphilis (nodular/lichenoid variant in Fitzpatrick VI skin) with possible prozone-masked RPR","score":4,"correct":true},{"id":"case_2016_20","title":"Case 20-2016 \u2014 A 50-Year-Old Man with Cloudy Vision, Hearing Loss, and Unsteadiness","year":"2016","ground_truth":"Secondary syphilis with neurologic, ocular, and otologic involvement.","our_diagnosis":"Ocular syphilis / otosyphilis (neurosyphilis) in HIV coinfection","score":5,"correct":true},{"id":"case_2016_21","title":"Case 21-2016 \u2014 A 32-Year-Old Man in an Unresponsive State","year":"2016","ground_truth":"Fulminant liver failure associated with hepatitis B virus infection.","our_diagnosis":"Acute severe hyperammonemia from late-onset/partial ornithine transcarbamylase (OTC) deficiency unmasked by catabolic stress (vomiting, illness)","score":4,"correct":true},{"id":"case_2016_22","title":"Case 22-2016 \u2014 A 65-Year-Old Man with Syncope, Dyspnea, and Leg Edema","year":"2016","ground_truth":"Sarcoidosis involving the heart and thoracic and inguinal lymph nodes.","our_diagnosis":"Systemic sarcoidosis with cardiac involvement (granulomatous basal septal pseudotumor) + extrapulmonary sarcoid (adrenal, skin, nodal)","score":5,"correct":true},{"id":"case_2016_23","title":"Case 23-2016 \u2014 A 46-Year-Old Man with Somnolence after Orthopedic Surgery","year":"2016","ground_truth":"The fat embolism syndrome.","our_diagnosis":"Cerebral Fat Embolism Syndrome (FES)","score":5,"correct":true},{"id":"case_2016_24","title":"Case 24-2016 \u2014 A 66-Year-Old Man with Malaise, Weakness, and Hypercalcemia","year":"2016","ground_truth":"The milk alkali syndrome.","our_diagnosis":"Calcium-alkali (milk-alkali) syndrome","score":5,"correct":true},{"id":"case_2016_25","title":"Case 25-2016 \u2014 A 33-Year-Old Man with Rectal Pain and Bleeding","year":"2016","ground_truth":"Syphilitic proctitis.","our_diagnosis":"Chronic idiopathic anal fissure (anterior/posterior midline) with perpetuation by naproxen + topical hydrocortisone, with mild distal proctitis likely representing NSAID proctopathy or enema-prep artifact","score":5,"correct":true},{"id":"case_2016_26","title":"Case 26-2016 \u2014 A 28-Year-Old Woman with Back Pain and a Lesion in the Lumbar Spine","year":"2016","ground_truth":"Giant-cell tumor of bone.","our_diagnosis":"Giant-cell tumor of bone (GCTB) of L5 with epidural extension, with probable secondary mechanical/steal effect on left iliac vasculature","score":5,"correct":true},{"id":"case_2016_27","title":"Case 27-2016 \u2014 A 71-Year-Old Woman with M\u00fcllerian Carcinoma, Fever, Fatigue, and Myalgias","year":"2016","ground_truth":"Transfusion-related babesiosis.","our_diagnosis":"Babesiosis (transfusion-transmitted Babesia microti, severe in asplenic host)","score":5,"correct":true},{"id":"case_2016_28","title":"Case 28-2016 \u2014 A 31-Year-Old Woman with Infertility","year":"2016","ground_truth":"Primary infertility due to Mycobacterium tuberculosis infection.","our_diagnosis":"Female Genital Tuberculosis (endometrial + tubal)","score":5,"correct":true},{"id":"case_2016_30","title":"Case 30-2016 \u2014 A 63-Year-Old Woman with Bipolar Disorder, Cancer, and Worsening Depression","year":"2016","ground_truth":"Bipolar I disorder with mixed features; invasive ductal carcinoma of the breast; lung cancer.","our_diagnosis":"New primary invasive carcinoma of the right breast (metachronous contralateral second primary)","score":4,"correct":true},{"id":"case_2016_31","title":"Case 31-2016 \u2014 A 53-Year-Old Man with Diplopia, Polydipsia, and Polyuria","year":"2016","ground_truth":"IgG4-related hypophysitis.","our_diagnosis":"Erdheim\u2013Chester disease (BRAF/MAPK-driven non-Langerhans histiocytosis)","score":4,"correct":true},{"id":"case_2016_32","title":"Case 32-2016 \u2014 A 20-Year-Old Man with Gynecomastia","year":"2016","ground_truth":"Intracranial germ-cell tumor (germinoma).","our_diagnosis":"Suprasellar intracranial germinoma (with or without \u03b2-hCG secretion, possibly on a background of Klinefelter syndrome)","score":5,"correct":true},{"id":"case_2016_33","title":"Case 33-2016 \u2014 A 30-Year-Old Woman with Severe Lower Abdominal Pain and Chill","year":"2016","ground_truth":"Tubo-ovarian abscess.","our_diagnosis":"Yersinia enterocolitica (or Campylobacter / non-typhoidal Salmonella) invasive ileocolitis with terminal ileitis, mesenteric adenitis, and reactive pelvic free fluid","score":3,"correct":false},{"id":"case_2016_34","title":"Case 34-2016 \u2014 A 17-Year-Old Boy with Myopia and Craniofacial and Skeletal Abnormalities","year":"2016","ground_truth":"Homocystinuria caused by cystathionine _-synthase deficiency.","our_diagnosis":"Classical Homocystinuria (cystathionine \u03b2-synthase / CBS deficiency)","score":5,"correct":true},{"id":"case_2016_35","title":"Case 35-2016 \u2014 A 62-Year-Old Man with Dysphagia","year":"2016","ground_truth":"Poorly differentiated, metastatic esophageal adenocarcinoma with MET amplification and a PIK3CA mutation.","our_diagnosis":"Metastatic (Stage IV) poorly differentiated adenocarcinoma of the gastroesophageal junction \u2014 dominant nodal spread pattern","score":5,"correct":true},{"id":"case_2016_36","title":"Case 36-2016 \u2014 A 50-Year-Old Man with Acute Liver Injury","year":"2016","ground_truth":"Acute HEV infection.","our_diagnosis":"Severe babesiosis (Babesia microti) acquired in New England","score":5,"correct":true},{"id":"case_2016_37","title":"Case 37-2016 \u2014 An 86-Year-Old Woman with Leukocytosis and Splenomegaly","year":"2016","ground_truth":"Chronic neutrophilic leukemia, with a CSF3R mutation.","our_diagnosis":"Chronic Myeloid Leukemia (CML), chronic phase (BCR-ABL1 positive)","score":3,"correct":false},{"id":"case_2016_38","title":"Case 38-2016 \u2014 A 52-Year-Old Woman with Recurrent Oligodendroglioma","year":"2016","ground_truth":"Oligodendroglioma (World Health Organization grade II out of IV), with an elevated Ki-67 proliferation index, an IDH1 R132H mutation, and codeletion of 1p and 19q.","our_diagnosis":"Slow volumetric progression of residual WHO grade II oligodendroglioma (without histologic transformation)","score":5,"correct":true},{"id":"case_2016_39","title":"Case 39-2016 \u2014 A 74-Year-Old Man with Rectal Bleeding and a History of Prostate Cancer","year":"2016","ground_truth":"Anal squamous-cell carcinoma, positive for human papillomavirus, after brachytherapy for prostate cancer.","our_diagnosis":"Squamous cell carcinoma of the anal canal","score":5,"correct":true},{"id":"case_2016_40","title":"Case 40-2016 \u2014 A 14-Month-Old Girl with Recurrent Vomiting","year":"2016","ground_truth":"Aqueductal stenosis with hydrocephalus.","our_diagnosis":"Intracranial mass lesion causing obstructive/communicating hydrocephalus (choroid plexus papilloma, pilocytic astrocytoma, medulloblastoma/ependymoma, or third-ventricular/suprasellar lesion)","score":4,"correct":true},{"id":"case_2017_01","title":"Case 1-2017 \u2014 A 70-Year-Old Woman with Gradually Progressive Loss of Language","year":"2017","ground_truth":"Primary progressive aphasia, semantic variant, due to TAR DNA-binding protein 43 (TDP-43)\u2013associated frontotemporal lobar degeneration, type C.","our_diagnosis":"Semantic variant Primary Progressive Aphasia (svPPA / semantic dementia)","score":5,"correct":true},{"id":"case_2017_02","title":"Case 2-2017 \u2014 An 18-Year-Old Woman with Acute Liver Failure","year":"2017","ground_truth":"Fulminant hepatic failure due to Wilson's disease.","our_diagnosis":"Fulminant Wilson disease unmasked by pregnancy/postpartum state","score":5,"correct":true},{"id":"case_2017_04","title":"Case 4-2017 \u2014 A 2-Month-Old Girl with Growth Retardation and Respiratory Failure","year":"2017","ground_truth":"Pulmonary-capillary hemangiomatosis and X-linked periventricular heterotopia associated with a mutation in FLNA.","our_diagnosis":"FLNA (Filamin A) loss-of-function mutation \u2014 X-linked periventricular nodular heterotopia with cardiopulmonary and connective-tissue involvement","score":5,"correct":true},{"id":"case_2017_05","title":"Case 5-2017 \u2014 A 19-Year-Old Man with Hematuria and a Retroperitoneal Mass","year":"2017","ground_truth":"Castleman's disease, hyaline-vascular type.","our_diagnosis":"Unicentric Castleman disease, hyaline-vascular variant","score":5,"correct":true},{"id":"case_2017_06","title":"Case 6-2017 \u2014 A 57-Year-Old Woman with Fatigue, Sweats, Weight Loss, Headache, and Skin Lesions","year":"2017","ground_truth":"IgG4-related vasculitis.","our_diagnosis":"IgG4-Related Disease (systemic: Mikulicz syndrome, IgG4-related sclerosing cholangitis/autoimmune hepatitis, lymphadenopathy, IgG4-related periarteritis of temporal arteries)","score":5,"correct":true},{"id":"case_2017_07","title":"Case 7-2017 \u2014 A 73-Year-Old Man with Confusion and Recurrent Epistaxis","year":"2017","ground_truth":"ascular malformations in the liver, stomach, esophagus, and lungs that are consistent with hereditary hemorrhagic telangiectasia, complicated by massive gastrointestinal hemorrhage.","our_diagnosis":"Hereditary Hemorrhagic Telangiectasia (HHT / Osler-Weber-Rendu) with hepatic AVM and portosystemic shunt \u2014 the unifying syndromic diagnosis","score":5,"correct":true},{"id":"case_2017_08","title":"Case 8-2017 \u2014 A 39-Year-Old Zimbabwean Man with a Severe Headache","year":"2017","ground_truth":"Cryptococcal meningitis in a patient with chronic human immunodeficiency virus infection.","our_diagnosis":"Cryptococcal meningitis (Cryptococcus neoformans), likely with underlying HIV/AIDS","score":5,"correct":true},{"id":"case_2017_09","title":"Case 9-2017 \u2014 A 27-Year-Old Woman with Nausea, Vomiting, Confusion, and Hyponatremia","year":"2017","ground_truth":"Primary adrenal insufficiency (Addison's disease).","our_diagnosis":"Primary adrenal insufficiency with Addisonian crisis (likely autoimmune adrenalitis)","score":5,"correct":true},{"id":"case_2017_10","title":"Case 10-2017 \u2014 A 6-Month-Old Boy with Gastrointestinal Bleeding and Abdominal Pain","year":"2017","ground_truth":"Meckel's diverticulum with heterotopic gastric mucosa and associated peptic ulceration in the intestinal mucosa.","our_diagnosis":"Meckel's diverticulum with ectopic gastric mucosa causing ileal ulceration and hemorrhage (\u00b1 transient intussusception with Meckel's as lead point)","score":5,"correct":true},{"id":"case_2017_11","title":"Case 11-2017 \u2014 A 61-Year-Old Woman with Leg Swelling, Back Pain, and Hydronephrosis","year":"2017","ground_truth":"Follicular lymphoma (grade 1\u20132 of 3; stage IV of IV) with a follicular pattern.","our_diagnosis":"Follicular lymphoma (indolent B-cell non-Hodgkin lymphoma)","score":5,"correct":true},{"id":"case_2017_12","title":"Case 12-2017 \u2014 A 34-Year-Old Man with Nephropathy","year":"2017","ground_truth":"Collapsing variant of focal segmental glomerulosclerosis that is consistent with HIV-associated nephropathy.","our_diagnosis":"Advanced HIV/AIDS with HIV-associated nephropathy (HIVAN, collapsing FSGS)","score":5,"correct":true},{"id":"case_2017_13","title":"Case 13-2017 \u2014 A 41-Year-Old Man with Hearing Loss, Seizures, Weakness, and Cognitive Decline","year":"2017","ground_truth":"MELAS (mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes).","our_diagnosis":"MELAS syndrome, m.3243A>G in MT-TL1 (most likely), with probable superimposed thiamine deficiency","score":5,"correct":true},{"id":"case_2017_14","title":"Case 14-2017 \u2014 A 20-Year-Old Man with Pain and Swelling of the Left Calf and a Purpuric Rash","year":"2017","ground_truth":"IgA vasculitis.","our_diagnosis":"IgA vasculitis (Henoch\u2013Sch\u00f6nlein purpura), post-streptococcal, with concurrent erythema nodosum","score":5,"correct":true},{"id":"case_2017_15","title":"Case 15-2017 \u2014 A 27-Year-Old Woman with Anemia, Thrombocytosis, and Skin Lesions after Travel Abroad","year":"2017","ground_truth":"Takayasu's arteritis.","our_diagnosis":"Takayasu arteritis (with cutaneous/mucocutaneous manifestations)","score":5,"correct":true},{"id":"case_2017_16","title":"Case 16-2017 \u2014 A 69-Year-Old Woman with Urinary Incontinence","year":"2017","ground_truth":"Leiomyosarcoma, high grade, conventional type.","our_diagnosis":"Uterine leiomyosarcoma (or STUMP) with intratumoral hemorrhage","score":5,"correct":true},{"id":"case_2017_17","title":"Case 17-2017 \u2014 A 14-Year-Old Boy with Acute Fear of Choking while Swallowing","year":"2017","ground_truth":"Pseudohypoparathyroidism type 1b.","our_diagnosis":"22q11.2 deletion syndrome (DiGeorge / velocardiofacial syndrome) with late-presenting hypoparathyroidism unmasked by puberty","score":3,"correct":false},{"id":"case_2017_18","title":"Case 18-2017 \u2014 An 11-Year-Old Girl with Difficulty Eating after a Choking Incident","year":"2017","ground_truth":"Avoidant\u2013restrictive food intake disorder (ARFID).","our_diagnosis":"Avoidant/Restrictive Food Intake Disorder (ARFID) \u2014 combined sensory-aversion + post-traumatic (fear of aversive consequences) subtypes","score":5,"correct":true},{"id":"case_2017_19","title":"Case 19-2017 \u2014 A 53-Year-Old Woman with Leg Numbness and Weakness","year":"2017","ground_truth":"Diffuse large B-cell lymphoma consistent with neurolymphomatosis.","our_diagnosis":"Methotrexate/TNF-\u03b1-associated EBV-positive B-cell lymphoproliferative disorder (other iatrogenic immunodeficiency-associated LPD; DLBCL type) presenting as neurolymphomatosis with lymphomatous meningitis","score":5,"correct":true},{"id":"case_2017_20","title":"Case 20-2017 \u2014 A 48-Year-Old Man with Weight Loss, Confusion, Skin Lesions, and Pancytopenia","year":"2017","ground_truth":"Advanced acquired immunodeficiency syndrome (AIDS) complicated by human immunodeficiency virus type 1 (HIV-1) encephalopathy.\n\nBasal-cell carcinoma.\n\nKaposi's sarcoma.","our_diagnosis":"Secondary syphilis (lues maligna) with neurosyphilis (general paresis + meningovascular/syphilitic encephalitis) and concurrent HIV infection","score":4,"correct":true},{"id":"case_2017_22","title":"Case 22-2017 \u2014 A 21-Year-Old Woman with Fever, Headache, and Myalgias\nList of authors.","year":"2017","ground_truth":"Probable acute leptospirosis.","our_diagnosis":"Severe leptospirosis with Pulmonary Hemorrhage Syndrome (Leptospira spp.)","score":5,"correct":true},{"id":"case_2017_23","title":"Case 23-2017 \u2014 A 9-Day-Old Girl with Vomiting, Acidosis, and Azotemia","year":"2017","ground_truth":"Food protein\u2013induced enterocolitis syndrome.","our_diagnosis":"Hirschsprung disease with Hirschsprung-associated enterocolitis (HAEC)","score":4,"correct":true},{"id":"case_2017_24","title":"Case 24-2017 \u2014 An 8-Month-Old Girl with Fever and an Abdominal Mass\nList of authors.","year":"2017","ground_truth":"Congenital pancreatic hamartoma (multicystic adenomatoid hamartoma).","our_diagnosis":"Enteric (foregut) duplication cyst of the pancreas with ectopic gastric mucosa and anomalous communication with the main pancreatic duct","score":1,"correct":false},{"id":"case_2017_25","title":"Case 25-2017 \u2014 A 45-Year-Old Man with Headache, Fever, and Lymphadenopathy","year":"2017","ground_truth":"Atypical immunoblastic reaction that was consistent with primary Epstein\u2013Barr virus infection.","our_diagnosis":"Classical Hodgkin Lymphoma (advanced stage, likely EBV-associated)","score":4,"correct":true},{"id":"case_2017_26","title":"Case 26-2017 \u2014 A 63-Year-Old Woman with Fever, Hypotension, and Hypoxemia","year":"2017","ground_truth":"Cytomegalovirus pneumonitis.","our_diagnosis":"Disseminated/pulmonary coccidioidomycosis","score":4,"correct":true},{"id":"case_2017_27","title":"Case 27-2017 \u2014 A 32-Year-Old Man with Acute Chest Pain","year":"2017","ground_truth":"Acute and chronic cholecystitis and extensive cholelithiasis with transmural gallbladder inflammation.","our_diagnosis":"Acute pericarditis / myopericarditis (likely viral or post-streptococcal)","score":2,"correct":false},{"id":"case_2017_28","title":"Case 28-2017 \u2014 A 13-Month-Old Girl with Pneumonia and a 33-Year-Old Woman with Hip Pain","year":"2017","ground_truth":"Autosomal dominant heterozygous IFN_R1 deficiency.\n\nDisseminated Mycobacterium genavense infection.","our_diagnosis":"Mendelian Susceptibility to Mycobacterial Disease (MSMD) \u2014 inherited IL-12/IFN-\u03b3 axis defect (e.g., IL-12R\u03b21 deficiency, partial dominant IFN-\u03b3R1 deficiency, STAT1, or IRF8) \u2014 with disseminated non-tuberculous mycobacterial infection in the child (most likely MAC or M. genavense from canary exposure) and disseminated reactivated BCG (M. bovis) or NTM osteomyelitis in the mother","score":5,"correct":true},{"id":"case_2017_29","title":"Case 29-2017 \u2014 A 59-Year-Old Woman with Pain and Swelling in the Right Hand and Ankles","year":"2017","ground_truth":"Septic arthritis due to disseminated infection with Neisseria gonorrhoeae.","our_diagnosis":"Disseminated gonococcal infection (purulent septic arthritis variant)","score":5,"correct":true},{"id":"case_2017_30","title":"Case 30-2017 \u2014 A 65-Year-Old Woman with Altered Mental Status, Bacteremia, and Acute Liver Failure","year":"2017","ground_truth":"Campylobacter bacteremia in a patient with presumed autoimmune hepatitis.","our_diagnosis":"Campylobacter fetus subsp. fetus bacteremia complicating autoimmune hepatitis flare with acute-on-chronic liver failure","score":5,"correct":true},{"id":"case_2017_31","title":"Case 31-2017 \u2014 A 19-Month-Old Girl with Failure to Thrive\nList of authors.","year":"2017","ground_truth":"The diencephalic syndrome due to a pilomyxoid astrocytoma.","our_diagnosis":"Diencephalic syndrome of Russell due to hypothalamic/optic pathway low-grade glioma (pilocytic astrocytoma)","score":5,"correct":true},{"id":"case_2017_32","title":"Case 32-2017 \u2014 A 64-Year-Old Man with Dyspnea, Wheezing, Headache, Cough, and Night Sweats","year":"2017","ground_truth":"Eosinophilic granulomatosis with polyangiitis.","our_diagnosis":"Eosinophilic Granulomatosis with Polyangiitis (EGPA) presenting with temporal-arteritis-like large-vessel involvement","score":5,"correct":true},{"id":"case_2017_34","title":"Case 34-2017 \u2014 A 76-Year-Old Man with Fever, Weight Loss, and Weakness","year":"2017","ground_truth":"West Nile virus encephalitis.","our_diagnosis":"Eastern Equine Encephalitis (EEE) virus neuroinvasive disease","score":4,"correct":true},{"id":"case_2017_35","title":"Case 35-2017 \u2014 A 57-Year-Old Woman with Hypoesthesia and Weakness in the Legs and Arms","year":"2017","ground_truth":"Copper deficiency myelopathy.","our_diagnosis":"Copper deficiency myelopathy (post\u2013gastric bypass, likely zinc-potentiated from denture adhesive)","score":5,"correct":true},{"id":"case_2017_36","title":"Case 36-2017 \u2014 A 30-Year-Old Man with Fatigue, Rash, Anemia, and Thrombocytopenia","year":"2017","ground_truth":"Combined inherited and acquired thrombotic thrombocytopenic purpura.","our_diagnosis":"Babesiosis (Babesia microti), likely with concurrent Lyme disease","score":4,"correct":true},{"id":"case_2017_37","title":"Case 37-2017 \u2014 A 36-Year-Old Man with Unintentional Opioid Overdose","year":"2017","ground_truth":"Unintentional opioid overdose, possibly from heroin mixed with fentanyl.\n\nOpioid-induced noncardiogenic pulmonary edema.","our_diagnosis":"Acute opioid (heroin/fentanyl) overdose in severe opioid use disorder","score":5,"correct":true},{"id":"case_2017_38","title":"Case 38-2017 \u2014 A 20-Year-Old Woman with Seizures and Progressive Dystonia","year":"2017","ground_truth":"Biotin\u2013thiamine\u2013responsive basal ganglia disease due to a homozygous c.1264A_G (p.Thr422Ala) mutation in SLC19A3.","our_diagnosis":"Biotin-Thiamine-Responsive Basal Ganglia Disease (SLC19A3)","score":5,"correct":true},{"id":"case_2017_39","title":"Case 39-2017 \u2014 A 41-Year-Old Woman with Recurrent Chest Pain","year":"2017","ground_truth":"Spontaneous coronary-artery dissection.","our_diagnosis":"Spontaneous coronary artery dissection (SCAD), likely on a background heritable arteriopathy","score":5,"correct":true},{"id":"case_2017_40","title":"Case 40-2017 \u2014 A 32-Year-Old Woman with Headache, Abdominal Pain, Anemia, and Thrombocytopenia","year":"2017","ground_truth":"Paroxysmal nocturnal hemoglobinuria.","our_diagnosis":"Antiphospholipid syndrome (likely secondary to SLE) with catastrophic/severe presentation","score":4,"correct":true},{"id":"case_2018_01","title":"Case 1-2018: A 39-Year-Old Woman with Rapidly Progressive Respiratory Failure\nList of authors.","year":"2018","ground_truth":"Adenovirus infection, disseminated.","our_diagnosis":"Human metapneumovirus (hMPV) lower respiratory tract infection with diffuse alveolar damage","score":4,"correct":true},{"id":"case_2018_02","title":"Case 2-2018: A 41-Year-Old Woman with Vision Disturbances and Headache","year":"2018","ground_truth":"Intracranial hypertension associated with systemic lupus erythematosus and glucocorticoid use.","our_diagnosis":"Neuro-Beh\u00e7et's disease with cerebral venous sinus thrombosis (intracranial hypertension)","score":4,"correct":true},{"id":"case_2018_03","title":"Case 3-2018: A 5-Month-Old Boy with Hypoglycemia","year":"2018","ground_truth":"Glycogen storage disease type Ia.","our_diagnosis":"Glycogen Storage Disease type Ia (von Gierke) or Ib","score":5,"correct":true},{"id":"case_2018_04","title":"Case 4-2018: A Newborn with Thrombocytopenia, Cataracts, and Hepatosplenomegaly","year":"2018","ground_truth":"Congenital rubella syndrome.","our_diagnosis":"Congenital Rubella Syndrome (CRS)","score":5,"correct":true},{"id":"case_2018_05","title":"Case 5-2018: A 63-Year-Old Man with Confusion after Stem-Cell Transplantation","year":"2018","ground_truth":"Human herpesvirus 6\u2013related meningoencephalitis.\n\nHuman herpesvirus 6\u2013related myocarditis and interstitial nephritis.","our_diagnosis":"HHV-6 encephalitis (post-transplant reactivation, atypical/extralimbic)","score":5,"correct":true},{"id":"case_2018_06","title":"Case 6-2018: A 35-Year-Old Woman with Headache, Subjective Fever, and Anemia","year":"2018","ground_truth":"Anemia due to parvovirus B19 infection and autoimmune hemolytic anemia.","our_diagnosis":"Parvovirus B19 transient aplastic crisis superimposed on underlying (compensated) hereditary spherocytosis","score":4,"correct":true},{"id":"case_2018_07","title":"Case 7-2018: A 25-Year-Old Man with New-Onset Seizures","year":"2018","ground_truth":"Homocystinuria due to genetic mutations of the gene encoding cystathionine _-synthase (CBS)","our_diagnosis":"Classical homocystinuria (cystathionine beta-synthase deficiency), likely pyridoxine-responsive variant","score":5,"correct":true},{"id":"case_2018_08","title":"Case 8-2018: A 55-Year-Old Woman with Shock and Labile Blood Pressure","year":"2018","ground_truth":"Catecholamine-induced cardiotoxicity due to pheochromocytoma.","our_diagnosis":"Sporadic pheochromocytoma or paraganglioma with catecholamine-induced recurrent takotsubo/cardiomyopathy","score":5,"correct":true},{"id":"case_2018_09","title":"Case 9-2018: A 55-Year-Old Man with HIV Infection and a Mass on the Right Side of the Face","year":"2018","ground_truth":"Burkitt-like lymphoma with 11q aberrations.","our_diagnosis":"Disseminated Mycobacterium avium complex (MAC)","score":4,"correct":true},{"id":"case_2018_10","title":"Case 10-2018: An 84-Year-Old Man with Painless Unilateral Testicular Swelling","year":"2018","ground_truth":"Mycobacterial epididymo-orchitis due to Mycobacterium tuberculosis.","our_diagnosis":"Primary testicular diffuse large B-cell lymphoma (DLBCL)","score":4,"correct":true},{"id":"case_2018_11","title":"Case 11-2018: A 48-Year-Old Woman with Recurrent Venous Thromboembolism and Pulmonary Artery Aneurysm\nList of authors.","year":"2018","ground_truth":"Pulmonary artery aneurysm that was most likely due to the Hughes\u2013Stovin syndrome.","our_diagnosis":"Beh\u00e7et disease with vascular involvement (vasculo-Beh\u00e7et / Hughes\u2013Stovin syndrome)","score":5,"correct":true},{"id":"case_2018_13","title":"Case 13-2018: A 53-Year-Old Man with Cardiomyopathy and Recurrent Ventricular Tachycardia","year":"2018","ground_truth":"Giant-cell myocarditis.","our_diagnosis":"Giant-Cell Myocarditis (GCM)","score":5,"correct":true},{"id":"case_2018_14","title":"Case 14-2018: A 68-Year-Old Woman with a Rash, Hyponatremia, and Uveitis","year":"2018","ground_truth":"Rickettsiosis of the spotted fever group.","our_diagnosis":"Indian tick typhus / Mediterranean spotted fever (Rickettsia conorii subsp. indica, spotted fever group)","score":5,"correct":true},{"id":"case_2018_15","title":"Case 15-2018: An 83-Year-Old Woman with Nausea, Vomiting, and Confusion","year":"2018","ground_truth":"Digoxin toxicity.","our_diagnosis":"SARS-CoV-2 (COVID-19) infection with atypical geriatric presentation (delirium-predominant, GI-prominent)","score":4,"correct":true},{"id":"case_2018_16","title":"Case 16-2018: A 45-Year-Old Man with Fever, Thrombocytopenia, and Elevated Aminotransferase Levels","year":"2018","ground_truth":"Anaplasma phagocytophilum infection","our_diagnosis":"Spotted fever group rickettsiosis (RMSF, R. parkeri)","score":4,"correct":true},{"id":"case_2018_17","title":"Case 17-2018: A 40-Year-Old Woman with Leg Swelling and Abdominal Distention and Pain","year":"2018","ground_truth":"Membranous nephropathy, PLA2R type.","our_diagnosis":"Primary (PLA2R-associated) membranous nephropathy with nephrotic syndrome","score":5,"correct":true},{"id":"case_2018_18","title":"Case 18-2018: A 45-Year-Old Woman with Hypertension, Fatigue, and Altered Mental Status","year":"2018","ground_truth":"Cushing's syndrome due to a well-differentiated, low-grade thymic neuroendocrine tumor with corticotropin secretion.","our_diagnosis":"Ectopic ACTH syndrome (paraneoplastic Cushing) from a bronchial/thymic carcinoid, small-cell neuroendocrine tumor, MTC, or pancreatic NET","score":5,"correct":true},{"id":"case_2018_19","title":"Case 19-2018: A 15-Year-Old Girl with Acute Kidney Injury","year":"2018","ground_truth":"Atypical hemolytic\u2013uremic syndrome.","our_diagnosis":"Shiga toxin-producing E. coli (STEC) hemolytic uremic syndrome (typical/D+ HUS)","score":4,"correct":true},{"id":"case_2018_20","title":"Case 20-2018: A 64-Year-Old Man with Fever, Arthralgias, and Testicular Pain","year":"2018","ground_truth":"Polyarteritis nodosa.","our_diagnosis":"Hepatitis B virus\u2013associated polyarteritis nodosa (PAN)","score":5,"correct":true},{"id":"case_2018_21","title":"Case 21-2018: A 61-Year-Old Man with Grandiosity, Impulsivity, and Decreased Sleep","year":"2018","ground_truth":"Poststroke mania and the frontal lobe syndrome.","our_diagnosis":"Primary Bipolar I disorder, late-recognized \u2014 current manic episode unmasked by alcohol relapse, sleep deprivation, and prior antidepressant exposure; with comorbid alcohol-induced cardiomyopathy and alcoholic cerebellar degeneration","score":4,"correct":true},{"id":"case_2018_22","title":"Case 22-2018: A 64-Year-Old Man with Progressive Leg Weakness, Recurrent Falls, and Anemia","year":"2018","ground_truth":"Vitamin C deficiency (scurvy). Vitamin B6, folate, zinc, and selenium defi\u0002ciencies. Alcohol-use disorder.","our_diagnosis":"Scurvy (severe vitamin C deficiency)","score":5,"correct":true},{"id":"case_2018_23","title":"Case 23-2018: A 36-Year-Old Man with Episodes of Confusion and Hypoglycemia","year":"2018","ground_truth":"Well-differentiated pancreatic neuroendocrine tumor, grade 1","our_diagnosis":"Insulinoma (pancreatic beta-cell tumor)","score":5,"correct":true},{"id":"case_2018_24","title":"Case 24-2018: A 71-Year-Old Man with Acute Renal Failure and Hematuria","year":"2018","ground_truth":"Anti\u2013glomerular basement membrane disease.","our_diagnosis":"Adult-onset IgA vasculitis (Henoch\u2013Sch\u00f6nlein purpura) without prominent skin involvement \u2014 systemic small-vessel vasculitis with synchronous glomerular and mesenteric capillaritis, triggered by familial viral illness","score":4,"correct":true},{"id":"case_2018_25","title":"Case 25-2018: A 63-Year-Old Man with Syncope","year":"2018","ground_truth":"Aortocoronary saphenous-vein\u2013graft aneurysm.","our_diagnosis":"Saphenous vein graft (SVG-to-PDA) aneurysm with mural thrombus and calcified wall \u2014 the structural diagnosis ('what is the mass')","score":5,"correct":true},{"id":"case_2018_26","title":"Case 26-2018: A 48-Year-Old Man with Fever, Chills, Myalgias, and Rash","year":"2018","ground_truth":"The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, associated with human herpesvirus 6 infection or reactivation","our_diagnosis":"DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)","score":5,"correct":true},{"id":"case_2018_27","title":"Case 27-2018: A 3-Year-Old Boy with Seizures","year":"2018","ground_truth":"Anti\u2013N-methyl-d-aspartate (NMDA) receptor encephalitis.","our_diagnosis":"Anti-NMDA receptor (anti-NMDAR) encephalitis","score":5,"correct":true},{"id":"case_2018_28","title":"Case 28-2018: A 39-Year-Old Man with Epistaxis, Pain and Erythema of the Forearm, and Pancytopenia","year":"2018","ground_truth":"Hairy-cell leukemia.","our_diagnosis":"Acute Leukemia (aleukemic presentation)","score":5,"correct":true},{"id":"case_2018_29","title":"Case 29-2018: A 31-Year-Old Woman with Infertility","year":"2018","ground_truth":"Complete androgen insensitivity syndrome","our_diagnosis":"Complete Androgen Insensitivity Syndrome (CAIS, 46,XY)","score":5,"correct":true},{"id":"case_2018_30","title":"Case 30-2018: A 66-Year-Old Woman with Chronic Abdominal Pain","year":"2018","ground_truth":"Colonic mass due to infection with an intravas\u0002cular nematode, most likely Angiostrongylus costaricensis","our_diagnosis":"Intestinal amebiasis with ameboma (Entamoeba histolytica)","score":4,"correct":true},{"id":"case_2018_32","title":"Case 32-2018: A 36-Year-Old Pregnant Woman with Newly Diagnosed Adenocarcinoma","year":"2018","ground_truth":"Poorly differentiated primary adenocarcinoma of the colon, with moderately differentiated metastatic adenocarcinoma in the liver and poorly differentiated metastatic carcinoma in the placenta.","our_diagnosis":"Conventional gastric adenocarcinoma (intestinal or diffuse/signet-ring type) with hepatic and nodal metastases","score":4,"correct":true},{"id":"case_2018_33","title":"Case 33-2018: A 57-Year-Old Man with Confusion, Fever, Malaise, and Weight Loss","year":"2018","ground_truth":"Pulmonary adenocarcinoma, complicated by a \nhypercoagulable state with nonbacterial throm\u0002botic endocarditis.","our_diagnosis":"Primary lung adenocarcinoma (mucin-producing) with Trousseau's syndrome and marantic (nonbacterial thrombotic) endocarditis","score":5,"correct":true},{"id":"case_2018_34","title":"Case 34-2018: A 58-Year-Old Woman with Paresthesia and Weakness of the Left Foot and Abdominal Wall","year":"2018","ground_truth":"Lyme meningoradiculitis","our_diagnosis":"Early disseminated Lyme neuroborreliosis with polyradiculoneuritis","score":5,"correct":true},{"id":"case_2018_35","title":"Case 35-2018: A 68-Year-Old Woman with Back Pain and a Remote History of Breast Cancer","year":"2018","ground_truth":"Hormone receptor\u2013positive, human epidermal growth factor receptor 2\u2013negative metastatic breast cancer of the lobular type, with ESR1 mutations.","our_diagnosis":"Metastatic recurrence of ER+ breast carcinoma (most likely invasive lobular subtype), with bone, visceral (splenic \u00b1 hepatic) involvement; left axillary/subpectoral nodes possibly reactive/incidental","score":5,"correct":true},{"id":"case_2018_36","title":"Case 36-2018: A 29-Year-Old Man with an Incidentally Discovered Renal Mass","year":"2018","ground_truth":"The t(6;11) TFEB translocation variant of renal\u0002cell carcinoma","our_diagnosis":"Hereditary leiomyomatosis and renal cell cancer (HLRCC; FH-deficient papillary type 2 RCC)","score":4,"correct":true},{"id":"case_2018_37","title":"Case 37-2018: A 23-Year-Old Woman with Vision Loss","year":"2018","ground_truth":"Susac's syndrome.","our_diagnosis":"Susac syndrome (retinocochleocerebral autoimmune endotheliopathy)","score":5,"correct":true},{"id":"case_2018_38","title":"Case 38-2018: A 54-Year-Old Man with New Heart Failure","year":"2018","ground_truth":"Heart failure due to aortic insufficiency and thoracic aortic aneurysm","our_diagnosis":"Severe aortic regurgitation from aortic root dilation (annuloaortic ectasia / hypertensive aortopathy), recently decompensated","score":5,"correct":true},{"id":"case_2018_39","title":"Case 39-2018: An 18-Year-Old Man with Diplopia and Proptosis of the Left Eye","year":"2018","ground_truth":"Granulomatosis with polyangiitis.","our_diagnosis":"Sarcoidosis (orbital \u00b1 salivary, Heerfordt-spectrum)","score":4,"correct":true},{"id":"case_2018_40","title":"Case 40-2018: A 47-Year-Old Woman with Recurrent Sinusitis, Cough, and Bronchiectasis","year":"2018","ground_truth":"Cystic fibrosis due to compound heterozygous CFTR Phe508del and D1152H mutations.","our_diagnosis":"Cystic fibrosis (adult/late-presenting) or CFTR-related disorder","score":5,"correct":true},{"id":"case_2019_01","title":"Case 1-2019: A 34-Year-Old Veteran with Multiple Somatic Symptoms","year":"2019","ground_truth":"Post-traumatic stress disorder.","our_diagnosis":"Post-Traumatic Stress Disorder (combat-related, chronic)","score":5,"correct":true},{"id":"case_2019_02","title":"Case 2-2019: A 36-Year-Old Man with Rash, Abdominal Pain, and Lymphadenopathy","year":"2019","ground_truth":"Papulonecrotic tuberculid (cutaneous tuberculosis).","our_diagnosis":"Disseminated non-tuberculous mycobacterial infection","score":4,"correct":true},{"id":"case_2019_03","title":"Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy","year":"2019","ground_truth":"Powassan virus encephalitis.","our_diagnosis":"Powassan virus (deer tick virus, lineage II) meningoencephalitis","score":5,"correct":true},{"id":"case_2019_04","title":"Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia","year":"2019","ground_truth":"Perforation of the sigmoid colon by a foreign body (toothpick) that caused a fistula to the right common iliac artery.","our_diagnosis":"Perforated appendicitis with appendiceal artery pseudoaneurysm (rare)","score":2,"correct":false},{"id":"case_2019_05","title":"Case 5-2019: A 48-Year-Old Woman with Delusional Thinking and Paresthesia of the Right Hand","year":"2019","ground_truth":"Pernicious anemia (vitamin B12 deficiency)","our_diagnosis":"Severe Vitamin B12 (cobalamin) deficiency with 'megaloblastic madness,' subacute combined degeneration, and dimorphic-anemia bicytopenia","score":5,"correct":true},{"id":"case_2019_06","title":"Case 6-2019: A 29-Year-Old Woman with Nausea, Vomiting, and Diarrhea","year":"2019","ground_truth":"Oxycodone and cocaine use.","our_diagnosis":"Severe Opioid Use Disorder (with acute opioid withdrawal as the presenting illness)","score":4,"correct":true},{"id":"case_2019_07","title":"Case 7-2019: A 73-Year-Old Woman with Swelling of the Right Groin and Fever","year":"2019","ground_truth":"Herpes simplex virus lymphadenitis. Chronic lymphocytic leukemia.","our_diagnosis":"Disseminated mycobacterial lymphadenitis (NTM \u2014 e.g., M. avium complex, M. kansasii, M. marinum \u2014 or reactivation TB)","score":4,"correct":true},{"id":"case_2019_08","title":"Case 8-2019: A 58-Year-Old Woman with Vision Loss, Headaches, and Oral Ulcers","year":"2019","ground_truth":"Ocular syphilis.","our_diagnosis":"Ocular syphilis with neurosyphilis (acute syphilitic posterior placoid chorioretinitis + meningovascular/parenchymal CNS involvement)","score":5,"correct":true},{"id":"case_2019_09","title":"Case 9-2019: A 62-Year-Old Man with Atrial Fibrillation, Depression, and Worsening Anxiety","year":"2019","ground_truth":"Symptomatic atrial fibrillation with associated anxiety","our_diagnosis":"Cardiac amyloidosis (AL or ATTR) with autonomic and peripheral neuropathy","score":4,"correct":true},{"id":"case_2019_10","title":"Case 10-2019: A 69-Year-Old Man with Progressive Dyspnea","year":"2019","ground_truth":"Idiopathic pulmonary fibrosis","our_diagnosis":"Chronic (fibrotic) Hypersensitivity Pneumonitis","score":4,"correct":true},{"id":"case_2019_12","title":"Case 12-2019: A 60-Year-Old Man with Weakness and Difficulty Chewing","year":"2019","ground_truth":"Motor neuron disease with TAR DNA-binding protein 43 proteinopathy.\nAmyotrophic lateral sclerosis.\nAcute bronchopneumonia","our_diagnosis":"Kennedy Disease (Spinobulbar Muscular Atrophy, SBMA) \u2014 X-linked CAG repeat expansion in AR gene","score":4,"correct":true},{"id":"case_2019_13","title":"Case 13-2019: A 54-Year-Old Man with Alcohol Withdrawal and Altered Mental Status","year":"2019","ground_truth":"Surreptitious ingestion of isopropyl alcohol.","our_diagnosis":"Phenobarbital toxicity / over-sedation (DEMOTED)","score":5,"correct":true},{"id":"case_2019_14","title":"Case 14-2019: A 44-Year-Old Man with Neck Pain and Swelling","year":"2019","ground_truth":"Metastatic postpubertal immature teratoma.","our_diagnosis":"Pseudoaneurysm / arteriovenous fistula of a small subclavian/cephalic branch","score":4,"correct":true},{"id":"case_2019_15","title":"Case 15-2019: A 55-Year-Old Man with Jaundice","year":"2019","ground_truth":"Acute hepatitis B virus and hepatitis delta virus coinfection in the presence of chronic hepatitis C virus infection","our_diagnosis":"Acute Hepatitis B Virus (HBV) infection with serum-sickness-like prodrome","score":2,"correct":false},{"id":"case_2019_16","title":"Case 16-2019: A 53-Year-Old Man with Cough and Eosinophilia","year":"2019","ground_truth":"Tropical pulmonary eosinophilia","our_diagnosis":"Chronic Strongyloidiasis with pulmonary involvement (\u00b1 coexistent sinobronchial disease)","score":4,"correct":true},{"id":"case_2019_17","title":"Case 17-2019: A 44-Year-Old Man with Joint Pain, Weight Loss, and Chest Pain","year":"2019","ground_truth":"Systemic lupus erythematosus.","our_diagnosis":"Adult-Onset Still's Disease (AOSD) with severe polyserositis \u00b1 early MAS evolution","score":4,"correct":true},{"id":"case_2019_18","title":"Case 18-2019: A 24-Year-Old Woman with a Pelvic Mass","year":"2019","ground_truth":"Anaplastic carcinoma arising in association with intestinal-type mucinous carcinoma of the ovary.","our_diagnosis":"Embryonal carcinoma of the ovary (pure or predominant)","score":2,"correct":false},{"id":"case_2019_19","title":"Case 19-2019: A 38-Year-Old Woman with Abdominal Pain and Fever","year":"2019","ground_truth":"Intestinal tuberculosis.","our_diagnosis":"Medically refractory systemic Crohn's disease with extraintestinal manifestations and current penetrating complication (phlegmon/microperforation)","score":4,"correct":true},{"id":"case_2019_20","title":"Case 20-2019: A 52-Year-Old Woman with Fever and Rash after Heart Transplantation","year":"2019","ground_truth":"Chronic Chagas' disease with reactivation of latent Trypanosoma cruzi infection","our_diagnosis":"Reactivated Trypanosoma cruzi infection (Chagas disease) with cutaneous reactivation panniculitis","score":5,"correct":true},{"id":"case_2019_21","title":"Case 21-2019: A 31-Year-Old Woman with Vision Loss","year":"2019","ground_truth":"Leber's hereditary optic neuropathy","our_diagnosis":"Leber Hereditary Optic Neuropathy (LHON)","score":5,"correct":true},{"id":"case_2019_22","title":"Case 22-2019: A 65-Year-Old Woman with Weakness, Dark Urine, and Dysphagia","year":"2019","ground_truth":"Statin-associated autoimmune myopathy","our_diagnosis":"Anti-SRP immune-mediated necrotizing myopathy (with cardiac involvement)","score":4,"correct":true},{"id":"case_2019_23","title":"Case 23-2019: A 52-Year-Old Man with Fever, Cough, and Hypoxemia","year":"2019","ground_truth":"Flail mitral valve due to acute myocardial infarc\u0002tion of the papillary muscle in the absence of obstructive coronary artery disease.","our_diagnosis":"Aortic valve infective endocarditis with septic embolization to the RCA (posterior MI) and acute severe aortic regurgitation","score":4,"correct":true},{"id":"case_2019_24","title":"Case 24-2019: A 39-Year-Old Woman with Palpitations, Abdominal Pain, and Vomiting","year":"2019","ground_truth":"Hyperthyroidism due to Graves' disease.","our_diagnosis":"Thyroid storm (decompensated Graves' thyrotoxicosis)","score":5,"correct":true},{"id":"case_2019_25","title":"Case 25-2019: A 41-Year-Old Pregnant Woman with Abdominal Pain","year":"2019","ground_truth":"Acute suppurative appendicitis and periappendicitis.","our_diagnosis":"Acute appendicitis (early, possibly with localized gangrene/microperforation)","score":5,"correct":true},{"id":"case_2019_26","title":"Case 26-2019: A 27-Year-Old Woman with Opioid Use Disorder and Suicidal Ideation","year":"2019","ground_truth":"Opioid use disorder and malingering.","our_diagnosis":"Severe Opioid Use Disorder / Polysubstance Use Disorder (heroin, fentanyl, cocaine, benzodiazepines, alcohol)","score":4,"correct":true},{"id":"case_2019_27","title":"Case 27-2019: A 16-Year-Old Girl with Head Trauma during a Sailboat Race","year":"2019","ground_truth":"Concussion, benign paroxysmal positional vertigo, and attention deficit\u2013hyperactivity disorder.","our_diagnosis":"Post-Concussion Syndrome with vestibulo-ocular and convergence-insufficiency subtypes","score":4,"correct":true},{"id":"case_2019_28","title":"Case 28-2019: A 22-Year-Old Woman with Dyspnea and Chest Pain","year":"2019","ground_truth":"Interstitial lung disease associated with FLNA\nmutation","our_diagnosis":"FLNA (Filamin A) loss-of-function \u2014 X-linked dominant filaminopathy with periventricular nodular heterotopia\u2013cardiopulmonary\u2013connective-tissue spectrum","score":5,"correct":true},{"id":"case_2019_29","title":"Case 29-2019: A 14-Month-Old Boy with Vomiting","year":"2019","ground_truth":"Congenital esophageal stenosis with fibromus\u0002cular thickening of the esophagus.","our_diagnosis":"Eosinophilic Esophagitis (EoE) with possible feeding-related impaction","score":4,"correct":true},{"id":"case_2019_30","title":"Case 30-2019: A 65-Year-Old Woman with Lung Cancer and Chest Pain","year":"2019","ground_truth":"Active myocarditis consistent with myocarditis related to immune checkpoint inhibition.","our_diagnosis":"ICI-related pericarditis / myopericarditis (dry)","score":4,"correct":true},{"id":"case_2019_31","title":"Case 31-2019: A 45-Year-Old Woman with Headache and Somnolence","year":"2019","ground_truth":"Adenovirus (serotype 2) meningoencephalitis.","our_diagnosis":"Powassan virus / Deer tick virus (Powassan lineage 2) encephalitis in a B-cell\u2013depleted host","score":3,"correct":false},{"id":"case_2019_32","title":"Case 32-2019: A 70-Year-Old Woman with Rapidly Progressive Ataxia\nC","year":"2019","ground_truth":"Creutzfeldt\u2013Jakob disease","our_diagnosis":"Sporadic Creutzfeldt\u2013Jakob Disease (cerebellar/Brownell\u2013Oppenheimer variant)","score":5,"correct":true},{"id":"case_2019_33","title":"Case 33-2019: A 35-Year-Old Woman with Cardiopulmonary Arrest during Cesarean Section","year":"2019","ground_truth":"Amniotic fluid embolism","our_diagnosis":"Amniotic Fluid Embolism (Anaphylactoid Syndrome of Pregnancy)","score":5,"correct":true},{"id":"case_2019_34","title":"Case 34-2019: A 16-Year-Old Boy with Jaundice","year":"2019","ground_truth":"B-cell acute lymphoblastic leukemia","our_diagnosis":"Autoimmune Hepatitis","score":4,"correct":true},{"id":"case_2019_35","title":"Case 35-2019: A 66-Year-Old Man with Pancytopenia and Rash","year":"2019","ground_truth":"Skin involvement associated with peripheral T-cell lymphoma most consistent with primary cutaneous gamma\u2013delta T-cell lymphoma","our_diagnosis":"Intravascular Large B-Cell Lymphoma (IVLBCL) with secondary HLH","score":4,"correct":true},{"id":"case_2019_36","title":"Case 36-2019: A 34-Year-Old Man with Dyspnea, Odynophagia, and Abdominal Pain","year":"2019","ground_truth":"Kaposi's sarcoma of the gastrointestinal tract","our_diagnosis":"CMV esophagogastritis (\u00b1 CMV colitis) with localized tissue-invasive disease and negative blood PCR","score":4,"correct":true},{"id":"case_2019_37","title":"Case 37-2019: A 20-Month-Old Boy with Severe Anemia","year":"2019","ground_truth":"Juvenile myelomonocytic leukemia.","our_diagnosis":"Metastatic Neuroblastoma (Stage M/4) with bone marrow infiltration and paraneoplastic reactive thrombocytosis","score":4,"correct":true},{"id":"case_2019_40","title":"Case 40-2019: A 26-Year-Old Returning Traveler with Headache","year":"2019","ground_truth":"Lymphocytic choriomeningitis virus infection.","our_diagnosis":"Tuberculous meningitis (TBM)","score":4,"correct":true},{"id":"case_2020_01","title":"Case 1-2020: An 11-Year-Old Boy with Vomiting and Weight Loss","year":"2020","ground_truth":"Autoimmune primary adrenal insufficiency and \nceliac disease","our_diagnosis":"Primary Adrenal Insufficiency due to X-linked Adrenoleukodystrophy (ABCD1) \u2014 possibly via contiguous Xq28 deletion syndrome","score":4,"correct":true},{"id":"case_2020_02","title":"Case 2-2020: A 64-Year-Old Man with Fever and Respiratory Failure","year":"2020","ground_truth":"Disseminated coccidioidomycosis and ANCA associated glomeruloneph","our_diagnosis":"Disseminated Coccidioidomycosis (reactivated/disseminated by iatrogenic immunosuppression) \u2014 with the original 4.5-month illness representing undiagnosed primary pulmonary coccidioidomycosis that triggered secondary MPO-ANCA positivity","score":5,"correct":true},{"id":"case_2020_03","title":"Case 3-2020: A 44-Year-Old Man with Weight Loss, Diarrhea, and Abdominal Pain","year":"2020","ground_truth":"Strongyloidiasis with human T-lymphotropic virus type 1 infection","our_diagnosis":"Strongyloides stercoralis hyperinfection syndrome (with probable HTLV-1 co-infection)","score":5,"correct":true},{"id":"case_2020_04","title":"Case 4-2020: A 52-Year-Old Woman with Seizure Disorder and Wide-Complex Tachycardia","year":"2020","ground_truth":"Antiepileptic drug toxicity","our_diagnosis":"Mitochondrial encephalomyopathy (MELAS or POLG-related disorder) with mitochondrial cardiomyopathy and stroke-like episode","score":4,"correct":true},{"id":"case_2020_05","title":"Case 5-2020: A 32-Day-Old Male Infant with a Fall","year":"2020","ground_truth":"Intraparenchymal and intracranial hemorrhage presumably due to birth trauma.","our_diagnosis":"Abusive head trauma / battered child syndrome with prior occult event","score":2,"correct":false},{"id":"case_2020_06","title":"Case 6-2020: A 34-Year-Old Woman with Hyperglycemia","year":"2020","ground_truth":"Maturity-onset diabetes of the young due to a GCK variant.","our_diagnosis":"GCK-MODY (MODY 2) \u2014 Glucokinase mutation","score":5,"correct":true},{"id":"case_2020_07","title":"Case 7-2020: A 52-Year-Old Man with a Mass in the Left Breast","year":"2020","ground_truth":"Invasive ductal carcinoma, grade 3, with metastatic carcinoma in 1 of 19 lymph nod","our_diagnosis":"Germline BRCA2 mutation (Ashkenazi founder 6174delT most likely) \u2014 hereditary breast/ovarian/pancreatic/prostate cancer syndrome","score":5,"correct":true},{"id":"case_2020_08","title":"Case 8-2020: An 89-Year-Old Man with Recurrent Abdominal Pain and Bloody Stools","year":"2020","ground_truth":"Ulcerative colitis.","our_diagnosis":"Cholesterol embolization syndrome (atheroembolic disease) from AAA mural thrombus causing chronic recurrent ischemic pancolitis; CMV and C. difficile were superinfections of necrotic mucosa","score":4,"correct":true},{"id":"case_2020_09","title":"Case 9-2020: A 64-Year-Old Man with Shortness of Breath, Cough, and Hypoxemia","year":"2020","ground_truth":"Aspergillus terreus infection associated with toxic effects induced by immune checkpoint inhibitor therapy (pneumonitis, colitis, and motor axonal neuropathy) and metastatic melanoma without evidence of active disease.","our_diagnosis":"Pneumocystis jirovecii Pneumonia (PJP) unmasked by steroid taper","score":2,"correct":false},{"id":"case_2020_10","title":"Case 10-2020: An 83-Year-Old Man with Pancytopenia and Acute Renal Failure","year":"2020","ground_truth":"Anaplasma phagocytophilum infection.","our_diagnosis":"Babesiosis (severe, dominant) as a co- or sole infection","score":4,"correct":true},{"id":"case_2020_11","title":"Case 11-2020: A 37-Year-Old Man with Facial Droop, Dysarthria, and Kidney Failure","year":"2020","ground_truth":"AA amyloidosis complicated by cerebral mucor\u0002mycosis.","our_diagnosis":"Cerebral mucormycosis (basal-ganglia tropism in IVDU) + AA (secondary) amyloidosis of kidney from chronic skin-popping abscesses","score":5,"correct":true},{"id":"case_2020_12","title":"Case 12-2020: A 24-Year-Old Man with Fever, Cough, and Dyspnea","year":"2020","ground_truth":"Hantavirus cardiopulmonary syndrome","our_diagnosis":"Hantavirus Cardiopulmonary Syndrome (HCPS) \u2014 likely Sin Nombre or related New World hantavirus","score":5,"correct":true},{"id":"case_2020_13","title":"Case 13-2020: A 29-Year-Old Man with High Blood Pressure, Renal Insufficiency, and Hematuria","year":"2020","ground_truth":"Crescentic IgA nephropathy","our_diagnosis":"IgA Nephropathy (Berger disease) with crescentic transformation","score":5,"correct":true},{"id":"case_2020_14","title":"Case 14-2020: A 37-Year-Old Man with Joint Pain and Eye Redness","year":"2020","ground_truth":"Proteinase 3 antineutrophil cytoplasmic antibody\u2013\nassociated vasculitis consistent with granuloma\u0002tosis with polyangiitis.","our_diagnosis":"Granulomatosis with Polyangiitis (GPA)","score":5,"correct":true},{"id":"case_2020_15","title":"Case 15-2020: A 79-Year-Old Man with Hyponatremia and Involuntary Movements of the Arm and Face","year":"2020","ground_truth":"LGI1 autoimmune encephalitis.","our_diagnosis":"Anti-LGI1 antibody-mediated autoimmune limbic encephalitis with faciobrachial dystonic seizures (pre-cognitive phase)","score":5,"correct":true},{"id":"case_2020_16","title":"Case 16-2020: A 47-Year-Old Woman with Recurrent Melanoma and Pulmonary Nodules","year":"2020","ground_truth":"Pulmonary histoplasmosis.","our_diagnosis":"Recurrent metastatic melanoma with hemorrhagic pulmonary metastases \u00b1 nodal recurrence","score":4,"correct":true},{"id":"case_2020_17","title":"Case 17-2020: A 68-Year-Old Man with Covid-19 and Acute Kidney Injury","year":"2020","ground_truth":"Acute kidney injury in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection","our_diagnosis":"Multifactorial Acute Tubular Necrosis from combined cardiogenic + septic + (possibly hemorrhagic) shock in severe COVID-19","score":5,"correct":true},{"id":"case_2020_18","title":"Case 18-2020: A 73-Year-Old Man with Hypoxemic Respiratory Failure and Cardiac Dysfunction","year":"2020","ground_truth":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with acute respiratory distress syndrome and suspected myopericarditis","our_diagnosis":"COVID-19 pneumonia with secondary myocardial injury (Type 2 MI / cytokine-mediated myocardial stunning \u00b1 microvascular thrombosis)","score":5,"correct":true},{"id":"case_2020_19","title":"Case 19-2020: A 74-Year-Old Man with Acute Respiratory Failure and Unclear Goals of Care","year":"2020","ground_truth":"Influenza A virus infection","our_diagnosis":"Pneumocystis jirovecii pneumonia (PJP)","score":3,"correct":false},{"id":"case_2020_20","title":"Case 20-2020: A 7-Year-Old Girl with Severe Psychological Distress after Family Separation","year":"2020","ground_truth":"Post-traumatic stress disorder.","our_diagnosis":"Post-Traumatic Stress Disorder (PTSD), childhood-onset, with comorbid Separation Anxiety Disorder","score":5,"correct":true},{"id":"case_2020_21","title":"Case 21-2020: A 66-Year-Old Homeless Man with Covid-19","year":"2020","ground_truth":"Severe acute respiratory syndrome coronavirus 2  (SARS-CoV-2) infection in a homeless patient.","our_diagnosis":"SARS-CoV-2 infection (COVID-19), severity UNDETERMINED \u2014 currently in peak deterioration window (Day 9\u201310 post-symptom-onset) with no objective clinical data","score":5,"correct":true},{"id":"case_2020_22","title":"Case 22-2020: A 62-Year-Old Woman with Early Breast Cancer during the Covid-19 Pandemic","year":"2020","ground_truth":"Invasive ductal carcinoma of the left breast, clinical prognostic stage IB (T2N0), estrogen receptor\u2013positive, progesterone receptor\u2013positive, human epidermal growth factor receptor 2\u2013nega\u0002tive, grade 2, with an intermediate recurrence score on the 21-gene assay","our_diagnosis":"Invasive ductal carcinoma (IDC) of no special type, left breast (clinical stage T2 cN0)","score":5,"correct":true},{"id":"case_2020_23","title":"Case 23-2020: A 76-Year-Old Woman Who Died from Covid-19","year":"2020","ground_truth":"Diffuse alveolar damage due to severe acute re\u0002spiratory syndrome coronavirus 2 (SARS-CoV-2) infection","our_diagnosis":"Severe COVID-19 pneumonia with diffuse alveolar damage (ARDS) \u2014 dominant underlying disease, contributory cause of death","score":5,"correct":true},{"id":"case_2020_24","title":"Case 24-2020: A 44-Year-Old Woman with Chest Pain, Dyspnea, and Shock","year":"2020","ground_truth":"SARS-CoV-2 infection complicated by severe acute \ninflammatory cardiomyopathy and cardiogenic \nshock","our_diagnosis":"Fulminant SARS-CoV-2-Associated Cardiac Injury (Myocarditis \u00b1 Microvascular Endotheliitis) with Cytokine Storm","score":5,"correct":true},{"id":"case_2020_25","title":"Case 25-2020: A 47-Year-Old Woman with a Lung Mass","year":"2020","ground_truth":"Pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection","our_diagnosis":"Paracoccidioidomycosis (chronic/reactivation pulmonary form)","score":4,"correct":true},{"id":"case_2020_27","title":"Case 27-2020: A 53-Year-Old Woman with Headache and Gait Imbalance","year":"2020","ground_truth":"Human immunodeficiency virus type 2 infection and cerebral toxoplasmosis.","our_diagnosis":"Disseminated endemic mycosis \u2014 African histoplasmosis (H. capsulatum var. duboisii), cryptococcosis, or other","score":4,"correct":true},{"id":"case_2020_28","title":"Case 28-2020: A 64-Year-Old Man with Intrusive Thoughts and Fear of Being Poisoned","year":"2020","ground_truth":"Post-traumatic stress disorder and major depres\u0002sive disorder in the context of culturally and re\u0002ligiously derived beliefs and behaviors.","our_diagnosis":"Delusional Disorder, Persecutory Type (with possible somatic features), comorbid with Recurrent MDD and Chronic PTSD","score":4,"correct":true},{"id":"case_2020_29","title":"Case 29-2020: A 66-Year-Old Man with Fever and Shortness of Breath after Liver Transplantation","year":"2020","ground_truth":"Severe acute respiratory syndrome coronavirus 2 infection.","our_diagnosis":"Severe COVID-19 pneumonia with ARDS in a solid-organ (liver) transplant recipient","score":5,"correct":true},{"id":"case_2020_30","title":"Case 30-2020: A 54-Year-Old Man with Sudden Cardiac Arrest","year":"2020","ground_truth":"Peudohyperaldosteronism suggestive of exces\u0002sive licorice consumption complicated by cardiac arrest associated with ventricular fibrillation.","our_diagnosis":"Glycyrrhizic acid (black licorice) toxicity causing apparent mineralocorticoid excess with hypokalemia-induced ventricular fibrillation","score":5,"correct":true},{"id":"case_2020_31","title":"Case 31-2020: A 48-Year-Old Man with Lymphoma and Abdominal Pain","year":"2020","ground_truth":"Disseminated cryptococcosis","our_diagnosis":"Progressive Disseminated Histoplasmosis (often with secondary HLH)","score":3,"correct":false},{"id":"case_2020_32","title":"Case 32-2020: A 63-Year-Old Man with Confusion, Fatigue, and Garbled Speech","year":"2020","ground_truth":"Borrelia miyamotoi infection.","our_diagnosis":"Neurosarcoidosis","score":2,"correct":false},{"id":"case_2020_33","title":"Case 33-2020: A 55-Year-Old Man with Abdominal Pain, Joint Swelling, and Skin Lesions","year":"2020","ground_truth":"Pancreatitis, panniculitis, and polyarthritis syn\u0002drome","our_diagnosis":"Pancreatitis, Panniculitis, and Polyarthritis (PPP) Syndrome \u2014 pancreatic panniculitis with osteoarticular fat necrosis","score":5,"correct":true},{"id":"case_2020_34","title":"Case 34-2020: A 74-Year-Old Man with Chronic Kidney Disease","year":"2020","ground_truth":"IgG4-related disease, with tubulointerstitial ne\u0002phritis, membranous nephropathy, and inflam\u0002matory pseudotumor involving the lacrimal gla","our_diagnosis":"IgG4-Related Disease (multi-organ): IgG4-related kidney disease with secondary membranous nephropathy, type 1 autoimmune pancreatitis (burned-out, calcified), IgG4-related dacryoadenitis/sialadenitis (Mikulicz disease), and IgG4-related coronary periarteritis with aneurysms","score":5,"correct":true},{"id":"case_2020_35","title":"Case 35-2020: A 59-Year-Old Woman with Type 1 Diabetes Mellitus and Obtundation\nC","year":"2020","ground_truth":"Aceruloplasminemia, hereditary","our_diagnosis":"Aceruloplasminemia (CP gene, autosomal recessive NBIA)","score":5,"correct":true},{"id":"case_2020_36","title":"Case 36-2020: A 72-Year-Old Woman with Dark Urine and Weakness","year":"2020","ground_truth":"Prosthetic paravalvular leak","our_diagnosis":"Paravalvular leak of mechanical mitral prosthesis (degenerative, secondary to progressive perimitral annular calcification) causing high-shear intravascular hemolysis","score":5,"correct":true},{"id":"case_2020_37","title":"Case 37-2020: A 35-Year-Old Man with Lymphadenopathy and Petechiae","year":"2020","ground_truth":"Necrotizing granulomatous lymphadenitis due to Mycobacterium tuberculosis complex.","our_diagnosis":"Classical Hodgkin lymphoma, nodular sclerosing subtype, with paraneoplastic ITP","score":4,"correct":true},{"id":"case_2020_38","title":"Case 38-2020: A 52-Year-Old Man with Cancer and Acute Hypoxemia","year":"2020","ground_truth":"Rasburicase-induced methemoglobinemia in the context of glucose-6-phosphate dehydrogenase deficiency. IgA lambda multiple myeloma","our_diagnosis":"Rasburicase-induced methemoglobinemia (\u00b1 oxidative hemolysis) unmasking G6PD deficiency \u2014 direct cause of the saturation gap on HD 5","score":5,"correct":true},{"id":"case_2020_39","title":"Case 39-2020: A 29-Month-Old Boy with Seizure and Hypocalcemia","year":"2020","ground_truth":"Vitamin D deficiency","our_diagnosis":"Nutritional vitamin D\u2013deficiency rickets (likely with co-existing dietary calcium deficiency) presenting with hypocalcemic seizure","score":5,"correct":true},{"id":"case_2020_40","title":"Case 40-2020: A 24-Year-Old Man with Headache and Covid-19","year":"2020","ground_truth":"Cryptococcal meningoencephalitis and advanced human immunodeficiency virus infection.","our_diagnosis":"Cryptococcal meningoencephalitis with gelatinous pseudocysts \u2014 species C. neoformans (HIV/immunocompromise) OR C. gattii (immunocompetent occupational exposure)","score":5,"correct":true},{"id":"case_2020_41","title":"Case 41-2020: A 62-Year-Old Man with Memory Loss and Odd Behavior","year":"2020","ground_truth":"Frontotemporal lobar degeneration with taupositive inclusions (FTLD-tau) consistent with Pick's disease","our_diagnosis":"Behavioral-variant Frontotemporal Dementia (bvFTD)","score":4,"correct":true},{"id":"case_2021_01","title":"Case 1-2021: A 76-Year-Old Woman with Lethargy and Altered Mental Status","year":"2021","ground_truth":"Mycobacterium tuberculosis meningitis","our_diagnosis":"Central nervous system tuberculosis (tuberculous meningitis with tuberculous arteritis \u00b1 tuberculomas) from primary pulmonary/pleural TB","score":5,"correct":true},{"id":"case_2021_02","title":"Case 2-2021: A 26-Year-Old Pregnant Woman with Ventricular Tachycardia and Shock","year":"2021","ground_truth":"Pregnancy-associated myocardial infarction, probably due to spontaneous coronary-artery dissection.","our_diagnosis":"Peripartum cardiomyopathy (PPCM) with secondary arrhythmia","score":4,"correct":true},{"id":"case_2021_03","title":"Case 3-2021: A 48-Year-Old Man with Transient Vision Loss","year":"2021","ground_truth":"Systemic primary amyloidosis","our_diagnosis":"Erdheim\u2013Chester Disease (BRAF V600E-associated non-Langerhans histiocytosis with bilateral orbital xanthogranuloma, retroperitoneal infiltration, long-bone osteosclerosis, and perivascular cranial-artery infiltration mimicking GCA)","score":4,"correct":true},{"id":"case_2021_04","title":"Case 4-2021: A 70-Year-Old Woman with Dyspnea on Exertion and Abnormal Findings on Chest Imaging","year":"2021","ground_truth":"Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.","our_diagnosis":"Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) with constrictive bronchiolitis and carcinoid tumorlets","score":5,"correct":true},{"id":"case_2021_05","title":"Case 5-2021: A 68-Year-Old Man with Delirium and Renal Insufficiency","year":"2021","ground_truth":"Disseminated Mycobacterium bovis infection","our_diagnosis":"Disseminated BCG infection (Mycobacterium bovis) with granulomatous aortitis (arch + abdominal) and septic/inflammatory cerebral emboli","score":5,"correct":true},{"id":"case_2021_06","title":"Case 6-2021: A 65-Year-Old Man with Eye Pain and Decreased Vision","year":"2021","ground_truth":"Lymphoplasmacytic lymphoma of the central nervous system (Bing\u2013Neel syndrome)","our_diagnosis":"Bing-Neel Syndrome (CNS/optic nerve sheath infiltration by Waldenstr\u00f6m macroglobulinemia, with possible skull-base/V3 trigeminal involvement)","score":5,"correct":true},{"id":"case_2021_07","title":"Case 7-2021: A 19-Year-Old Man with Shock, Multiple Organ Failure, and Rash","year":"2021","ground_truth":"Meningococcal purpura fulminans.","our_diagnosis":"Meningococcemia with Waterhouse\u2013Friderichsen syndrome and purpura fulminans (Neisseria meningitidis sepsis)","score":5,"correct":true},{"id":"case_2021_08","title":"Case 8-2021: A 34-Year-Old Woman with Cholangiocarcinoma","year":"2021","ground_truth":"Intrahepatic cholangiocarcinoma.","our_diagnosis":"Intrahepatic cholangiocarcinoma \u2014 molecularly unselected / no currently targetable driver","score":5,"correct":true},{"id":"case_2021_09","title":"Case 9-2021: A 16-Year-Old Boy with Headache, Abdominal Pain, and Hypertension","year":"2021","ground_truth":"Pheochromocytoma.","our_diagnosis":"Renovascular hypertension (fibromuscular dysplasia)","score":4,"correct":true},{"id":"case_2021_10","title":"Case 10-2021: A 70-Year-Old Man with Depressed Mood, Unsteady Gait, and Urinary Incontinence","year":"2021","ground_truth":"Normal pressure hydrocephalus","our_diagnosis":"Iatrogenic polypharmacy: antipsychotic-induced parkinsonism + valproate neurotoxicity, on a background of lumbar spinal stenosis","score":4,"correct":true},{"id":"case_2021_11","title":"Case 11-2021: A 39-Year-Old Woman with Fever, Flank Pain, and Inguinal Lymphadenopathy","year":"2021","ground_truth":"Bartonella henselae infection (cat scratch disease).","our_diagnosis":"Cat-scratch disease (Bartonella henselae) \u2014 hepatosplenic/disseminated form","score":5,"correct":true},{"id":"case_2021_12","title":"Case 12-2021: A 78-Year-Old Man with a Rash on the Scalp and Face","year":"2021","ground_truth":"Varicella\u2013zoster virus infection","our_diagnosis":"Disseminated Herpes Zoster Ophthalmicus (left V1) with cutaneous dissemination \u00b1 VZV CNS involvement","score":5,"correct":true},{"id":"case_2021_13","title":"Case 13-2021: A Newborn Girl with a Neck Mass","year":"2021","ground_truth":"Nodular follicular thyroid neoplasm with a somatic NRAS mutation.","our_diagnosis":"Congenital cervical neuroblastic tumor \u2014 neuroblastoma (classic, undifferentiated/poorly differentiated)","score":1,"correct":false},{"id":"case_2021_14","title":"Case 14-2021: A 64-Year-Old Woman with Fever and Pancytopenia","year":"2021","ground_truth":"Babesiosis.","our_diagnosis":"Visceral leishmaniasis with HLH","score":4,"correct":true},{"id":"case_2021_15","title":"Case 15-2021: A 76-Year-Old Woman with Nausea, Diarrhea, and Acute Kidney Failure","year":"2021","ground_truth":"Lactic acidosis due to toxic effects from metformin use","our_diagnosis":"Iatrogenic sequential-polypharmacy toxidrome (MALA + sulfonylurea + CNS depressant + warfarin accumulation) precipitated by metolazone-induced cardiorenal AKI","score":5,"correct":true},{"id":"case_2021_16","title":"Case 16-2021: A 37-Year-Old Woman with Abdominal Pain and Aortic Dilatation","year":"2021","ground_truth":"Staphylococcus aureus bacteremia and infection of a vascular graft.","our_diagnosis":"Mycotic (infected) infrarenal aortic aneurysm \u2014 gram-positive organism (Bacillus, Staphylococcus, Streptococcus, or Listeria) seeded from IV heroin use","score":5,"correct":true},{"id":"case_2021_17","title":"Case 17-2021: An 82-Year-Old Woman with Pain, Swelling, and Ecchymosis of the Left Arm","year":"2021","ground_truth":"Acquired factor VIII inhibitor","our_diagnosis":"Acquired Hemophilia A (autoantibody inhibitor against Factor VIII)","score":5,"correct":true},{"id":"case_2021_18","title":"Case 18-2021: An 81-Year-Old Man with Cough, Fever, and Shortness of Breath","year":"2021","ground_truth":"Pneumonia associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and acute pulmonary embolism.","our_diagnosis":"COVID-19 pneumonia (viral substrate) with concurrent acute pulmonary embolism as the proximate cause of acute decompensation","score":5,"correct":true},{"id":"case_2021_19","title":"Case 19-2021: A 54-Year-Old Man with Irritability, Confusion, and Odd Behaviors","year":"2021","ground_truth":"Delayed posthypoxic leukoencephalopathy","our_diagnosis":"Delayed Post-Hypoxic Leukoencephalopathy (DPHL / Grinker's myelinopathy)","score":5,"correct":true},{"id":"case_2021_20","title":"Case 20-2021: A 69-Year-Old Man with Ataxia","year":"2021","ground_truth":"Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome due to a biallelic expansion in RFC1","our_diagnosis":"CANVAS due to biallelic RFC1 AAGGG repeat expansion","score":5,"correct":true},{"id":"case_2021_21","title":"Case 21-2021: A 33-Year-Old Pregnant Woman with Fever, Abdominal Pain, and Headache","year":"2021","ground_truth":"Listeria monocytogenes bacteremia resulting in loss of fetus","our_diagnosis":"Listeria monocytogenes bacteremia (invasive listeriosis in pregnancy)","score":5,"correct":true},{"id":"case_2021_22","title":"Case 22-2021: A 64-Year-Old Woman with Cognitive Impairment, Headache, and Memory Loss","year":"2021","ground_truth":"Cerebral amyloid angiopathy\u2013related inflammation.","our_diagnosis":"Cerebral Amyloid Angiopathy\u2013Related Inflammation (CAA-ri) / Amyloid-\u03b2 Related Angiitis (ABRA)","score":5,"correct":true},{"id":"case_2021_23","title":"Case 23-2021: A 41-Year-Old Woman with Bloody Stools and Thrombocytopenia","year":"2021","ground_truth":"Cytomegalovirus-induced immune thrombocytopenia.","our_diagnosis":"Disseminated Human Adenovirus (HAdV) infection with hemorrhagic proctocolitis, hemorrhagic ureteritis/nephritis of the allograft, and virus-induced immune thrombocytopenia","score":4,"correct":true},{"id":"case_2021_24","title":"Case 24-2021: A 63-Year-Old Woman with Fever, Sore Throat, and Confusion","year":"2021","ground_truth":"Acute human immunodeficiency virus type 1 infection","our_diagnosis":"Acute HIV-1 infection (Fiebig III\u2013IV) with acute retroviral syndrome and HIV meningoencephalitis \u2014 present, but insufficient as sole diagnosis","score":5,"correct":true},{"id":"case_2021_25","title":"Case 25-2021: A 48-Year-Old Man with Fatigue and Leg Swelling","year":"2021","ground_truth":"Hereditary hemochromatosis.","our_diagnosis":"Hereditary Hemochromatosis (HFE C282Y homozygous) with decompensated cirrhosis, cardiomyopathy, type-3c diabetes, and hypogonadism \u2014 acutely decompensated","score":5,"correct":true},{"id":"case_2021_26","title":"Case 26-2021: A 49-Year-Old Man with Relapsed Acute Myeloid Leukemia","year":"2021","ground_truth":"Relapsed acute myeloid leukemia (with wild-type NPM1 and newly identified internal tandem duplication mutation in FLT3)","our_diagnosis":"Relapsed NPM1-mutated AML (same clone, DNMT3A/NPM1/NRAS persistence) \u2014 explains blasts, thrombocytopenia, LDH, but NOT all symptoms","score":4,"correct":true},{"id":"case_2021_28","title":"Case 28-2021: A 37-Year-Old Woman with Covid-19 and Suicidal Ideation","year":"2021","ground_truth":"Fear associated with coronavirus disease 2019 (Covid-19), causing suicidal ideation.","our_diagnosis":"COVID-19 with mixed neuropsychiatric syndrome: hypoactive encephalopathy/delirium superimposed on a reactive depressive episode with suicidal ideation","score":4,"correct":true},{"id":"case_2021_29","title":"Case 29-2021: A 12-Month-Old Boy with Fever and Developmental Regression","year":"2021","ground_truth":"Systemic juvenile idiopathic arthritis.","our_diagnosis":"Systemic Juvenile Idiopathic Arthritis (Still's disease) \u2014 with prior transient hepatic acute-phase reaction","score":5,"correct":true},{"id":"case_2021_30","title":"Case 30-2021: A 47-Year-Old Man with Recurrent Unilateral Head and Neck Pain","year":"2021","ground_truth":"Vascular Ehlers\u2013Danlos syndrome.","our_diagnosis":"Vascular Ehlers-Danlos Syndrome (vEDS, COL3A1)","score":5,"correct":true},{"id":"case_2021_31","title":"Case 31-2021: A 21-Year-Old Man with Sore Throat, Epistaxis, and Oropharyngeal Petechiae","year":"2021","ground_truth":"Severe acquired aplastic anemia after infection with severe acute respiratory syndrome coronavirus 2","our_diagnosis":"Aleukemic Acute Leukemia (most likely B-ALL or T-ALL; AML/myeloid sarcoma also possible)","score":4,"correct":true},{"id":"case_2021_32","title":"Case 32-2021: A 14-Year-Old Girl with Swelling of the Jaw and Hypercalcemia","year":"2021","ground_truth":"Primary hyperparathyroidism and brown tumor","our_diagnosis":"Sporadic primary hyperparathyroidism due to a solitary parathyroid adenoma, with a mandibular brown tumor (osteitis fibrosa cystica)","score":5,"correct":true},{"id":"case_2021_33","title":"Case 33-2021: A 68-Year-Old Man with Painful Mouth Ulcers","year":"2021","ground_truth":"Eosinophilic leukemia","our_diagnosis":"VEXAS Syndrome (UBA1 somatic mutation, adult-onset autoinflammation)","score":4,"correct":true},{"id":"case_2021_35","title":"Case 35-2021: A 50-Year-Old Woman with Pain in the Left Upper Quadrant and Hypoxemia","year":"2021","ground_truth":"Pneumocystis jirovecii pneumonia","our_diagnosis":"Hodgkin lymphoma (or other lymphoma) misdiagnosed as sarcoidosis, with sarcoid-like granulomatous reaction; superimposed acute pulmonary process (opportunistic infection vs. lymphomatous infiltration vs. MTX pneumonitis)","score":3,"correct":false},{"id":"case_2021_36","title":"Case 36-2021: A 22-Year-Old Man with Pain and Erythema of the Left Hand","year":"2021","ground_truth":"Erysipelothrix rhusiopathiae infection.","our_diagnosis":"Ulceroglandular/Glandular Tularemia (Francisella tularensis)","score":3,"correct":false},{"id":"case_2021_37","title":"Case 37-2021: A 60-Year-Old Man with Fevers, Fatigue, Arthralgias, a Mouth Ulcer, and a Rash","year":"2021","ground_truth":"Anti\u2013melanoma differentiation\u2013associated protein 5 (anti\u2013MDA-5) dermatomyositis","our_diagnosis":"Anti-MDA5 (anti-CADM-140) Dermatomyositis with Rapidly Progressive ILD","score":5,"correct":true},{"id":"case_2021_38","title":"Case 38-2021: A 76-Year-Old Woman with Abdominal Pain, Weight Loss, and Memory Impairment","year":"2021","ground_truth":"Lead poisoning","our_diagnosis":"Chronic lead poisoning (plumbism), most likely from Ayurvedic/herbal supplements provided by the daughter","score":5,"correct":true},{"id":"case_2021_39","title":"Case 39-2021: A 26-Year-Old Woman with Respiratory Failure and Altered Mental Status","year":"2021","ground_truth":"Fat embolism syndrome.","our_diagnosis":"Fat Embolism Syndrome (cerebral + pulmonary) following liposuction/abdominoplasty","score":5,"correct":true},{"id":"case_2021_40","title":"Case 40-2021: A 9-Year-Old Boy with Transient Weakness, Facial Droop, and Slurred Speech","year":"2021","ground_truth":"Moyamoya disease","our_diagnosis":"Moyamoya vasculopathy (most likely moyamoya SYNDROME secondary to an underlying genetic/prothrombotic disorder) with hyperventilation-induced TIA","score":5,"correct":true},{"id":"case_2022_01","title":"Case 1-2022: A 67-Year-Old Man with Motor Neuron Disease and Odd Behaviors during Sleep","year":"2022","ground_truth":"Anti-IgLON5 IgG\u2013associated neurologic disorder.","our_diagnosis":"Anti-IgLON5 disease (autoimmune tauopathy)","score":5,"correct":true},{"id":"case_2022_02","title":"Case 2-2022: A 70-Year-Old Man with a Recurrent Left Pleural Effusion","year":"2022","ground_truth":"VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome.","our_diagnosis":"VEXAS syndrome (somatic UBA1 mutation), possibly therapy-related clonal hematopoiesis","score":5,"correct":true},{"id":"case_2022_03","title":"Case 3-2022: A 14-Year-Old Boy with Fever, Joint Pain, and Abdominal Cramping","year":"2022","ground_truth":"Inflammatory bowel disease (Crohn's disease)","our_diagnosis":"New-onset Crohn's disease (ileocolonic \u00b1 upper GI) with peripheral (Type 1) enteropathic arthritis","score":5,"correct":true},{"id":"case_2022_04","title":"Case 4-2022: A 55-Year-Old Man with Bilateral Hearing Loss and Eye Redness","year":"2022","ground_truth":"Neurosyphilis.","our_diagnosis":"Otosyphilis / ocular syphilis / early neurosyphilis","score":5,"correct":true},{"id":"case_2022_05","title":"Case 5-2022: A 65-Year-Old Woman with Rapidly Progressive Weakness in the Right Arm and Recurrent Falls","year":"2022","ground_truth":"Genetic Creutzfeldt\u2013Jakob disease.","our_diagnosis":"Gerstmann-Str\u00e4ussler-Scheinker / Genetic prion disease (familial CJD)","score":5,"correct":true},{"id":"case_2022_06","title":"Case 6-2022: A 68-Year-Old Man with Fatigue, Weight Loss, and Hyperglycemia","year":"2022","ground_truth":"Immune checkpoint inhibitor\u2013induced diabetes","our_diagnosis":"Pembrolizumab (anti-PD-1) induced autoimmune type 1 diabetes mellitus presenting with diabetic ketosis (evolving DKA)","score":5,"correct":true},{"id":"case_2022_07","title":"Case 7-2022: A 65-Year-Old Woman with Depression, Recurrent Falls, and Inability to Care for Herself","year":"2022","ground_truth":"Diffuse large B-cell lymphoma.","our_diagnosis":"CSF1R-related Adult-onset Leukoencephalopathy with Axonal Spheroids and Pigmented Glia (ALSP / HDLS)","score":4,"correct":true},{"id":"case_2022_08","title":"Case 8-2022: A 54-Year-Old Woman with Episodes of Swelling.","year":"2022","ground_truth":"Hereditary angioedema with C1 inhibitor deficiency and chronic spontaneous urticaria","our_diagnosis":"Acquired C1-Inhibitor Deficiency (Type I AAE) secondary to an indolent B-cell lymphoproliferative disorder (most likely duodenal MALT or duodenal-type follicular lymphoma at the known subepithelial mass; CLL/SLL, splenic marginal zone lymphoma, or Waldenstr\u00f6m also possible) \u2014 with current acute bowel-wall angioedema attack","score":4,"correct":true},{"id":"case_2022_09","title":"Case 9-2022: A 56-Year-Old Woman \nwith Fever, Myalgias, Diarrhea, and Cough","year":"2022","ground_truth":"Anaplasmosis.","our_diagnosis":"Tularemia (Francisella tularensis) \u2014 typhoidal/pneumonic form","score":4,"correct":true},{"id":"case_2022_10","title":"Case 10-2022: A 78-Year-Old Man with Marked Ventricular Wall Thickening","year":"2022","ground_truth":"Fabry's disease.","our_diagnosis":"Fabry disease (\u03b1-galactosidase A deficiency) \u2014 likely later-onset cardiac variant rather than classic phenotype","score":5,"correct":true},{"id":"case_2022_11","title":"Case 11-2022: An 80-Year-Old Woman with Pancytopenia","year":"2022","ground_truth":"Myelodysplastic syndrome.","our_diagnosis":"Acquired (immune-mediated) thrombotic thrombocytopenic purpura (TTP) with severe ADAMTS13 deficiency, triggered by recent infection and/or Candida esophagitis on a background of MDS","score":4,"correct":true},{"id":"case_2022_12","title":"Case 12-2022: A 41-Year-Old Woman with Transient Ischemic Attack and Mitral Valve Masses","year":"2022","ground_truth":"Systemic lupus erythematosus with antiphospholipid syndrome","our_diagnosis":"Systemic Lupus Erythematosus with secondary Antiphospholipid Syndrome and Libman\u2013Sacks endocarditis","score":5,"correct":true},{"id":"case_2022_13","title":"Case 13-2022: A 56-Year-Old Man with Myalgias, Fever, and Bradycardia.","year":"2022","ground_truth":"Regional myocarditis due to infection with Listeria monocytogenes.","our_diagnosis":"Subacute infective endocarditis with aortic root/perivalvular abscess (\u00b1 metastatic spondylodiscitis)","score":3,"correct":false},{"id":"case_2022_14","title":"Case 14-2022: A 57-Year-Old Man with Chylous Ascites.","year":"2022","ground_truth":"High-grade B-cell lymphoma, not otherwise specified.","our_diagnosis":"B-cell non-Hodgkin lymphoma (DLBCL or small-bowel/MALT-type) arising in long-standing intestinal lymphangiectasia","score":4,"correct":true},{"id":"case_2022_15","title":"Case 15-2022: A 57-Year-Old Man with Persistent Cough and Pulmonary Opacities","year":"2022","ground_truth":"Aspiration pneumonia","our_diagnosis":"Invasive pulmonary aspergillosis (bronchopneumonic / airway-invasive form) superimposed on an aspiration substrate","score":4,"correct":true},{"id":"case_2022_16","title":"Case 16-2022: A 55-Year-Old Man with Fevers, Night Sweats, and a Mediastinal Mass","year":"2022","ground_truth":"Idiopathic multicentric Castleman's disease.","our_diagnosis":"IgG4-related disease","score":4,"correct":true},{"id":"case_2022_18","title":"Case 18-2022: A 29-Year-Old Woman with Recurrent Fractures","year":"2022","ground_truth":"Phosphaturic mesenchymal tumor causing osteomalacia","our_diagnosis":"Tumor-Induced (Oncogenic) Osteomalacia from FGF23-secreting phosphaturic mesenchymal tumor","score":5,"correct":true},{"id":"case_2022_19","title":"Case 19-2022: A 29-Year-Old Woman with Jaundice and Chronic Diarrhea","year":"2022","ground_truth":"Pancreatic ductal adenocarcinoma","our_diagnosis":"Hodgkin Lymphoma with paraneoplastic pruritus/eosinophilia and peripancreatic nodal conglomerate causing biliary/pancreatic obstruction","score":4,"correct":true},{"id":"case_2022_20","title":"Case 20-2022: A 25-Year-Old Man with Vision Changes","year":"2022","ground_truth":"Plasma-cell myeloma post-transplantation lymphoproliferative disorder.","our_diagnosis":"Lineage-switched BCR-ABL1+ leukemia with plasmacytic/plasmablastic differentiation (CD19-escape post-blinatumomab, sanctuary-site rebound after dasatinib withdrawal)","score":4,"correct":true},{"id":"case_2022_21","title":"Case 21-2022: A 17-Year-Old Girl with Fever and Cough","year":"2022","ground_truth":"Granulomatosis with polyangiitis","our_diagnosis":"ANCA-Associated Vasculitis (GPA > MPA)","score":5,"correct":true},{"id":"case_2022_22","title":"Case 22-2022: A 34-Year-Old Woman with Cavitary Lung Lesions","year":"2022","ground_truth":"Infection with Blastomyces dermatitidis.","our_diagnosis":"Reactivation TB / Non-tuberculous Mycobacteria (chronic 7-mm nodule)","score":4,"correct":true},{"id":"case_2022_23","title":"Case 23-2022: A 49-Year-Old Man with Hypoglycemia","year":"2022","ground_truth":"Well-differentiated pancreatic insulin-secreting neuroendocrine tumor (insulinoma).","our_diagnosis":"Insulinoma (pancreatic beta-cell neuroendocrine tumor)","score":5,"correct":true},{"id":"case_2022_24","title":"Case 24-2022: A 31-Year-Old Man with Perianal and Penile Ulcers, Rectal Pain, and Rash","year":"2022","ground_truth":"Infection with monkeypox virus, West African clade.","our_diagnosis":"Mpox (Monkeypox virus infection)","score":5,"correct":true},{"id":"case_2022_25","title":"Case 25-2022: A 25-Year-Old Woman with Headache and Blurred Vision","year":"2022","ground_truth":"Chronic Candida albicans meningitis.","our_diagnosis":"Tuberculous meningitis with basal exudate, basal/4th-ventricular tuberculoma, and tuberculous spinal arachnoiditis (lumbar 'mass' = loculated tuberculous pyo-exudate)","score":4,"correct":true},{"id":"case_2022_26","title":"Case 26-2022: A 48-Year-Old Woman with Cystic Lung Disease","year":"2022","ground_truth":"Langerhans-cell histiocytosis of the lung and liver.","our_diagnosis":"Multisystem Langerhans Cell Histiocytosis (PLCH with hepatic, thyroid involvement)","score":5,"correct":true},{"id":"case_2022_27","title":"Case 27-2022: A 32-Year-Old Man with Confusion, Headache, and Fever","year":"2022","ground_truth":"Encephalitis due to Beh\u201a\u00e0\u00f6\u221a\u00fcet's disease.","our_diagnosis":"Cryptococcal meningoencephalitis (despite negative CrAg)","score":4,"correct":true},{"id":"case_2022_28","title":"Case 28-2022: A 59-Year-Old Man with Headache and Progressive Neurologic Dysfunction","year":"2022","ground_truth":"Granulomatosis with polyangiitis.","our_diagnosis":"True IgG4-related hypertrophic pachymeningitis \u2014 refractory because of tissue plasma cells + poor CNS penetration of rituximab","score":4,"correct":true},{"id":"case_2022_29","title":"Case 29-2022: A 33-Year-Old Man with Chronic Diarrhea and Autoimmune Enteropathy","year":"2022","ground_truth":"Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome.","our_diagnosis":"LRBA deficiency or CTLA4 haploinsufficiency (CTLA-4 pathway disorder)","score":4,"correct":true},{"id":"case_2022_30","title":"Case 30-2022: A Newborn Girl with Hypoglycemia","year":"2022","ground_truth":"Neonatal hypoglycemia due to biologically active teratoma and the Sotos syndrome.","our_diagnosis":"Sacrococcygeal/presacral teratoma with paraneoplastic hyperinsulinemic hypoglycemia (ectopic insulin from intratumoral islet tissue OR NICTH from IGF-2/big-IGF-2)","score":2,"correct":false},{"id":"case_2022_31","title":"Case 31-2022: A 72-Year-Old Man with Heartburn, Nausea, and Inability to Eat","year":"2022","ground_truth":"Linitis plastica (invasive gastric adenocarcinoma).","our_diagnosis":"Diffuse-type gastric adenocarcinoma (signet-ring / linitis plastica) \u00b1 limited metastases","score":5,"correct":true},{"id":"case_2022_32","title":"Case 32-2022: A 76-Year-Old Man with Postoperative Cardiogenic Shock and Diffuse Rash","year":"2022","ground_truth":"Eosinophilic myocarditis and drug reaction with eosinophilia and systemic symptoms (DRESS).","our_diagnosis":"Post-cardiotomy ischemic/mixed cardiogenic-vasoplegic shock (early graft dysfunction or perioperative MI \u00b1 bypass-induced SIRS) WITH concurrent beta-lactam drug exanthem and peripheral eosinophilia","score":4,"correct":true},{"id":"case_2022_33","title":"Case 33-2022: An 11-Year-Old Girl with Redness of the Eyes","year":"2022","ground_truth":"Sarcoidosis.","our_diagnosis":"Tuberculosis \u2014 progressive primary / disseminated lymphohematogenous / ocular TB","score":4,"correct":true},{"id":"case_2022_34","title":"Case 34-2022: A 57-Year-Old Woman with Covid-19 and Delusions","year":"2022","ground_truth":"Cotard's syndrome, catatonia, depression, and seizure after coronavirus disease 2019.","our_diagnosis":"Major depressive episode with psychotic features (Cotard's syndrome) and catatonia, precipitated by COVID-19 and corticosteroid exposure","score":5,"correct":true},{"id":"case_2022_35","title":"Case 35-2022: A 60-Year-Old Man with Progressive Dyspnea, Neck Swelling, and a Lung Mass","year":"2022","ground_truth":"Poorly differentiated adenocarcinoma of the lung complicated by superior vena cava syndrome.","our_diagnosis":"Primary lung adenocarcinoma (advanced/locally-advanced NSCLC), complicated by SVC syndrome, tumor-associated PE (Trousseau physiology), probable chylothorax, and non-osmotic ADH release","score":5,"correct":true},{"id":"case_2022_36","title":"Case 36-2022: A 30-Year-Old Woman with Decreased Vision and Headache","year":"2022","ground_truth":"Meningioma, meningothelial type, World Health Organization grade 1.","our_diagnosis":"Optic nerve sheath meningioma (ONSM)","score":5,"correct":true},{"id":"case_2022_37","title":"Case 37-2022: A 55-Year-Old Man with Fatigue, Weight Loss, and Pulmonary Nodules","year":"2022","ground_truth":"Disseminated Mycobacterium tuberculosis infection.","our_diagnosis":"Disseminated tuberculosis (donor-derived or reactivation) with genitourinary involvement (ureteral stricture \u2192 allograft hydronephrosis + Tamm-Horsfall granulomas) and possible adrenal infiltration","score":5,"correct":true},{"id":"case_2022_38","title":"Case 38-2022: A 21-Year-Old Woman with Fatigue and Weight Gain","year":"2022","ground_truth":"Adrenocortical carcinoma.","our_diagnosis":"DUAL DIAGNOSIS: Right round ligament varicosity / pelvic venous congestion (chief complaint) + incidental cortisol-secreting adrenal adenoma with MACS (metabolic features)","score":4,"correct":true},{"id":"case_2022_39","title":"Case 39-2022: A 31-Year-Old Woman with Postpartum Abdominal Pain and Fever","year":"2022","ground_truth":"Hepatic adenoma.","our_diagnosis":"Left ovarian vein thrombophlebitis (septic pelvic thrombophlebitis) with extension to the left renal vein","score":1,"correct":false},{"id":"case_2022_40","title":"Case 40-2022: A 38-Year-Old Man with Exertional Chest Discomfort","year":"2022","ground_truth":"Cardiac paraganglioma with a germline mutation in the gene encoding succinate dehydrogenase subunit C (SDHC).","our_diagnosis":"Systemic mast cell disorder (indolent systemic mastocytosis or MCAS) with Kounis-type coronary vasospasm and bronchospasm","score":2,"correct":false},{"id":"case_2023_01","title":"Case 1-2023: A 49-Year-Old Man with Hypokalemia and Paranoia","year":"2023","ground_truth":"Cushing's syndrome due to ectopic secretion of adrenocorticotropic hormone from small-cell lung cancer.","our_diagnosis":"Ectopic ACTH syndrome (paraneoplastic Cushing's) from small-cell lung carcinoma \u2014 CHRONIC BACKGROUND DIAGNOSIS","score":5,"correct":true},{"id":"case_2023_02","title":"Case 2-2023: A 76-Year-Old Man with Dizziness and Altered Mental Status","year":"2023","ground_truth":"Chronic salicylate toxicity.","our_diagnosis":"Salicylate (aspirin/methyl-salicylate) toxicity \u2014 acute on chronic","score":5,"correct":true},{"id":"case_2023_03","title":"Case 3-2023: A 16-Year-Old Girl with Abdominal Pain and Bloody Diarrhea","year":"2023","ground_truth":"Catastrophic antiphospholipid syndrome.","our_diagnosis":"Systemic Lupus Erythematosus with mesenteric vasculitis (lupus enteritis) and secondary APS","score":4,"correct":true},{"id":"case_2023_04","title":"Case 4-2023: A 56-Year-Old Man with Abnormal Results on Liver Testing","year":"2023","ground_truth":"Primary biliary cholangitis with portopulmonary hypertension.","our_diagnosis":"Primary Biliary Cholangitis (PBC) with cirrhosis and portal hypertension","score":5,"correct":true},{"id":"case_2023_05","title":"Case 5-2023: A 67-Year-Old Man with Interstitial Lung Disease, Fever, and Myalgias","year":"2023","ground_truth":"Human granulocytic anaplasmosis.","our_diagnosis":"Human Granulocytic Anaplasmosis (Anaplasma phagocytophilum)","score":5,"correct":true},{"id":"case_2023_06","title":"Case 6-2023: A 68-Year-Old Man with Recurrent Strokes","year":"2023","ground_truth":"Paraneoplastic vasculitis of the central nervous system.","our_diagnosis":"Malignancy-associated paraneoplastic coagulopathy: Nonbacterial Thrombotic Endocarditis (NBTE) + chronic compensated DIC (Trousseau syndrome) from occult mucin-producing adenocarcinoma","score":4,"correct":true},{"id":"case_2023_07","title":"Case 7-2023: A 70-Year-Old Man with Covid-19, Respiratory Failure, and Rashes","year":"2023","ground_truth":"Mucormycosis.","our_diagnosis":"Disseminated Strongyloidiasis / Strongyloides hyperinfection syndrome","score":4,"correct":true},{"id":"case_2023_08","title":"Case 8-2023: A 71-Year-Old Woman with Refractory Hemolytic Anemia","year":"2023","ground_truth":"Breast cancer\u2013associated thrombotic microangiopathy.","our_diagnosis":"Scleroderma renal crisis (anti\u2013RNA pol III, steroid-triggered) complicated by transfusion-associated hyperhemolysis/macrophage activation","score":4,"correct":true},{"id":"case_2023_09","title":"Case 9-2023: A 20-Year-Old Man with Shortness of Breath and Proteinuria","year":"2023","ground_truth":"Systemic lupus erythematosus with membranous lupus nephritis","our_diagnosis":"Systemic Lupus Erythematosus with secondary Antiphospholipid Syndrome and Lupus Nephritis","score":5,"correct":true},{"id":"case_2023_10","title":"Case 10-2023: A 27-Year-Old Man with Convulsions","year":"2023","ground_truth":"Functional seizures.","our_diagnosis":"Functional (Psychogenic) Non-Epileptic Seizures (PNES) / Functional Neurological Disorder, seizure subtype","score":5,"correct":true},{"id":"case_2023_11","title":"Case 11-2023: A 67-Year-Old Man with Mantle-Cell Lymphoma and Hypoxemia","year":"2023","ground_truth":"Dapsone-induced methemoglobinemia.","our_diagnosis":"Dapsone-induced methemoglobinemia (primary driver of hypoxemia)","score":5,"correct":true},{"id":"case_2023_12","title":"Case 12-2023: A 44-Year-Old Woman with Muscle Weakness and Myalgia","year":"2023","ground_truth":"Hypocalcemic myopathy due to hypoparathyroidism","our_diagnosis":"Hypocalcemic tetany from decompensated autoimmune hypoparathyroidism (likely triggered by malabsorption or supplement dysregulation)","score":5,"correct":true},{"id":"case_2023_13","title":"Case 13-2023: A 25-Year-Old Woman with Abdominal Pain and Jerking Movements","year":"2023","ground_truth":"Factitious disorder.","our_diagnosis":"Factitious Disorder Imposed on Self (Munchausen Syndrome) with feigned/exaggerated porphyria","score":5,"correct":true},{"id":"case_2023_14","title":"Case 14-2023: A 31-Year-Old Man with Redness of the Right Eye","year":"2023","ground_truth":"Mpox conjunctivitis.","our_diagnosis":"Ocular mpox \u2014 MPXV blepharoconjunctivitis with associated episcleritis/scleritis (direct viral \u00b1 parainfectious immune)","score":5,"correct":true},{"id":"case_2023_15","title":"Case 15-2023: A 33-Year-Old Man with Paresthesia of the Arms and Legs","year":"2023","ground_truth":"Functional vitamin B12 deficiency from use of nitrous oxide.","our_diagnosis":"Nitrous oxide\u2013induced functional vitamin B12 deficiency with subacute combined degeneration (myeloneuropathy)","score":5,"correct":true},{"id":"case_2023_16","title":"Case 16-2023: A 13-Year-Old Boy with Depression and Hypotension","year":"2023","ground_truth":"Intentional guanfacine overdose.","our_diagnosis":"Infective endocarditis from recurrent skin-flora bacteremia","score":5,"correct":true},{"id":"case_2023_17","title":"Case 17-2023: A 58-Year-Old Woman with Fatigue, Abdominal Bloating, and Eosinophilia","year":"2023","ground_truth":"Mansonella perstans infection.","our_diagnosis":"Acute/early-chronic Schistosomiasis (S. mansoni or S. haematobium) \u2014 explains eosinophilia ONLY, not the calcifications or weight gain","score":4,"correct":true},{"id":"case_2023_18","title":"Case 18-2023: A 19-Year-Old Woman with Dyspnea and Tachypnea","year":"2023","ground_truth":"Takayasu's arteritis.","our_diagnosis":"Takayasu arteritis with severe aortic regurgitation, possible coronary ostial involvement, and acute decompensated heart failure","score":5,"correct":true},{"id":"case_260","title":"Bipolar I disorder with mixed features; invasive ductal carcinoma of the breast; lung cancer.","year":"2023","ground_truth":"Histoplasmosis of the breast.","our_diagnosis":"Invasive ductal carcinoma of the left breast with axillary nodal metastasis (likely high-grade, possibly triple-negative or HER2+)","score":3,"correct":false}]