Residents and ex-residents, what was your first *big* diagnosis?
I'm talking about the first strange or uncommon diagnosis you had, how you arrived at it, and how the patient did.
I was in PGY1, patient referred from Psychiatry, managed as Serotonin Syndrome due to multiple neuromodulator agents after she fell and suffered a back injury. Took history carefully, found out that the fall was relatively minor, went through her reports, found sky high ESR and a globulin level of 7, diagnosed multiple myeloma. Underwent BMT and is on follow up with Haemat now.