The Clinical Problem Solvers

A puzzling case of month-long spinning vertigo in a young woman leads to a hunt between vestibular and cerebellar causes. Normal imaging and mixed lab findings push the team toward autoimmune and gluten-related explanations. The story follows diagnostic tests, therapeutic trials, and a surprising diet-linked recovery.

For this episode of WDx, Sharmin and Kaylin are joined by Dr Alice Mao to discuss what they have learned about burnout so far and how their perspectives have changed over time. Alice Mao’s Bio:Dr. Alice Mao is an internal medicine and geriatric medicine physician who is passionate about social equity, community empowerment, and innovations in primary care. She was born in China and grew up in Canada and the US. She completed medical school at UCSF, internal medicine residency at the University of Washington, and geriatric medicine fellowship at Stanford. She is currently the Lead Geriatrician at Asian Health Services, where she is helping build a new geriatric clinic and a new Program of All-Inclusive Care for the Elderly (PACE) to better serve high frailty seniors in the community.  Outside of medicine, she enjoys spending time with family and friends, giving her cat cheek scratches, and resurrecting her childhood dreams of learning how to freestyle dance.    https://clinicalproblemsolving.com/wp-content/uploads/2026/03/WDx-3.19.26-final.m4a  Download CPSolvers App hereRLRCPSOLVERS  

A complex AKI case drives a rapid-fire question format exploring pre, post, and intrarenal causes. Detailed urinalysis interpretation and sudden severe azotemia prompt discussion of lab artifacts and chronicity. Bloodwork reveals microangiopathic hemolysis and thrombotic microangiopathy. Debate centers on distinguishing GN, malignant hypertension, and complement‑mediated TMA and the urgency of biopsy and targeted therapy.

Live recordings from Southern SGIM explore two dramatic clinical puzzles. One case follows a young man with fever, bloody diarrhea, multi-organ failure, hemolysis clues, and consideration of HLH. The other traces a teen with progressive neuropathy, pancytopenia, splenomegaly, and marrow findings leading to a lysosomal storage diagnosis. Energetic clinical reasoning and diagnostic detective work drive the conversation.

A dramatic ED case where a critical potassium of 7.9 triggers rapid decision making and team coordination. They debate bedside assessment versus ordering lifesaving therapies first. Practical steps for stabilizing severe hyperkalemia and sequencing treatments are reviewed. The diagnostic twist involves a swollen, painful knee leading to arthrocentesis and a final diagnosis of gout.

Zakariyya Ellemdin, a South African physician and case presenter, shares a puzzling young patient with psychiatric change, tremor, and liver findings. Sebastian Green, a UCLA neurology resident and educator, walks through neurologic reasoning, tremor phenomenology, and age-related liver-brain diagnoses. They compare tremor types, discuss Wilson disease testing, and outline practical neuro workup steps.

Lyra (Lira) is a first-year internal medicine resident and new member of the CPSolvers Academy. The conversation tackles a 45-year-old with progressive non-pitting swelling and mild eosinophilia. They explore vessel-based frameworks, how edema distribution guides diagnosis, the approach to eosinophilia, and the clinical reasoning that leads to eosinophilic fasciitis and its workup.

Uttara, a second-year infectious disease fellow at Stanford focused on antimicrobial stewardship and global health, presents a puzzling red eye case. The conversation moves from ocular localization and autoimmune versus infectious causes to lung and brain findings. They trace a disseminated mycobacterial infection linked to unpasteurized milk and discuss diagnostic clues and management nuances.

AMK (Anne‑Marie), a hospitalist at UNC who presented a clinical unknown, walks through a sneaky four‑week fever with liver injury. The conversation probes links between sinus symptoms, antibiotics, and hepatosplenomegaly. They weigh drug reactions, viral hepatitis, tickborne serologies, and testing strategies before confirming CMV hepatitis.

A 52-year-old with progressive left leg pain and weakness sparks a diagnostic puzzle. The team debates localization between spinal, cortical, vascular, and peripheral causes. Imaging, EMG, labs, and red flags guide a deep dive into lumbosacral plexopathy and systemic causes like malignancy, inflammatory disease, and metabolic disorders. The case evolves with bilateral progression and complex next-step reasoning.