Tell us about the most interesting case you were exposed to while attending medical school.

Question

Ryan Brunner · Accepted Answer

"The most intriguing case I was exposed to during medical school was a diagnosis of post-traumatic stress disorder in an elderly victim of a brutal crime following the loss of her spouse. Over time, the patient was moved to an assisted living facility and continued to develop severe psychotic symptoms and paranoia. The patient suffered from hallucinations and was moved to a psychiatric unit for further observation. A neuroleptic drug was finally prescribed and began to improve the patient's mental well-being."

Rachelle Enns · Answer

Your interviewers will be looking for the ideal candidates that have a passion for the specialty they want to pursue training in. This is a conversational-based question intended to get to know you a little bit better and the types of cases that you find to be the most interesting.

Ryan Brunner · Answer

Before your residency interview, think of what you consider the most intriguing and thought-provoking case you worked on in medical school. The cases that are most interesting to you should pertain to the specialty you want to pursue. As you answer, take a few minutes to set the stage for the case, name a couple of points that intrigued you the most, and talk about why. If you know the outcome of the case, discuss that briefly as well.

Dr. Shani Saks · Answer

The most interesting case I saw in my medical school training was a young woman who was in multisystem organ failure from severe pancreatitis. She languished in the ICU on a ventilator for months with minimal improvement. The case manager brought the intensive care doctor to the ethics committee, arguing for comfort care measures. The ICU doctor felt the patient would improve. She ended up waking up and waving us goodbye on her way to inpatient rehab.

Dr. Griswold · Answer

"I had an interesting case where I was working with a Family Medicine physician who discovered that a patient had cancer during a routine office visit. This solidified the power Family Medicine doctors have to be able to impact patients' lives."

Dr. Rodman · Answer

"I was involved in the delivery of a baby boy during my first year as a medical student. By chance, I happened to see this child multiple times in the pediatric clinic during my later clinical rotations. I was able to see firsthand how this little boy met his milestones and developed into a fun toddler. It was an amazing feeling to watch this child grow, knowing that I participated in his and his family's care."

Dr. Yumeen · Answer

"One of the most interesting cases was a patient with a chronic hand rash that had bothered him for many years. After numerous treatments were trialed without success, and multiple biopsies that were non-specific, a later biopsy revealed a diagnosis of cutaneous lymphoma. Following initiation of lymphoma treatment, the patient's rash drastically improved. It highlighted for me the role of a dermatologist in providing longitudinal care to patients and in diligently and determinedly searching for a diagnosis when it may be quite challenging. I was also in awe of how significant a quality of life improvement dermatologic care could make for patients."

Dr. Smith · Answer

"The most interesting case I saw as a medical student was in the Emergency Department and involved a woman who had been labeled as a "frequent flyer". She would always come in with vague complaints and receive broad workups which were essentially benign. Finally, one time, instead of brushing off her complaints as the "usual problems" a resident took time to sit down and talk with the woman about her personal life and what was bothering her outside of her stated issues. She found out that in addition to having housing insecurity, the woman was in an abusive relationship with a partner which she had previously been reluctant to admit. She was ultimately able to help that patient obtain social services and safe shelter and I think that was a great example of how sometimes a patient has issues that are deeper than we can see and that we as EM physicians need to take time to understand our patients as people in order to truly help them."

Anonymous User · Answer

"A 28-year-old female housewife came to us with the complaint of low-grade fever for 1 month. It was insidious in onset, not associated with rigors and chills, and relieved by medication. 4 to 5 days from the onset of fever, she started developing progressive weakness in all four limbs. She was having difficulty in walking, combing, and drinking a glass of water. But there was no sensory loss. In the next few days, she started developing swelling in the bilateral upper limb which progressed to the back of the neck. There was no periorbital or facial edema and no shortness of breath. Her urine output decreased but she was not having burning micturition or abdominal discomfort. She had no past medical or surgical history. No history of allergy. On examination, she was afebrile and her vitals were normal. Examination revealed bilateral upper limb soft tissue swelling, swelling on the back of the neck. Mild erythema and tenderness were also present but there was no crepitus. On neurological examination, cranial nerve and sensory system examination were normal but power was decreased to 3/5 in B/L LL and 2/5 in B/L UL. DTR was negative in all four limbs.

Labs revealed increased TLC (26000), Hyponatremia of 119, and increased BUN/creatinine. Urine examination showed increased RBC and pus cells. So, this patient with Areflexic quadriparesis without sensory and bladder bowel involvement developed subcutaneous edema with AKI and urosepsis, and dys-electrolytemia. Myopathy being one of the differentials, we sent CPK and LDH which came out to be elevated. Muscle biopsy was performed and pt was started on IV methylprednisolone. Subcutaneous edema and weakness improved after initiating steroids. Fever, TLC normalized after 6-7 days of antibiotic coverage. However, on day 10, she started developing dysphagia. We passed Ryle's tube and were started on plasmapheresis on the advice of neurology. Muscle biopsy results confirmed polymyositis. She was discharged oral prednisolone 30 mg."

Anonymous User · Answer

"When I was posted in the intensive care unit, there was a 40-year old male from the hilly region of Nepal who presented to the emergency with altered mental status, nausea, and vomiting and the patient's party gave a history of consumption of 50 grams of wild honey.

Lab review showed elevated creatinine from baseline and mild leukocytosis.

He was started on vasopressor and other supportive measures. He was diagnosed with a condition called Mad Honey disease.

Later I found that it is a rare condition that is seen in Nepal and some parts of Turkey."

Anonymous User · Answer

"The most interesting case I saw in my medical school training was a 40-year-old male whom I witnessed overdosing in the hospital psychiatric unit, he went into shock and declined to be in the ICU on a ventilator for months. I was in my following rotation, which was IM, and saw him still in the ICU. The doctors never gave up on him, and I saw him improving, waking up, and walking out of the hospital."

Tell us about the most interesting case you were exposed to while attending medical school.

How to Answer: Tell us about the most interesting case you were exposed to while attending medical school.

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39. Tell us about the most interesting case you were exposed to while attending medical school.

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