An 82-year-old woman presented to the emergency department with 2 months of diarrhea and 2 weeks of rash. She had sustained a left radius fracture 6 months prior, which resulted in deconditioning and poor appetite. Her diet consisted of mostly vegetables, and she lost 4 kg (8.8 lb) during this time. Two months prior, she developed postprandial nonbloody diarrhea that occurred 5 times daily. Two weeks prior, a pruritic rash in her extremities emerged. She had no fever, night sweats, or abdominal pain. Past medical history included chronic nondeforming rheumatoid arthritis, hypothyroidism, and colon adenocarcinoma resected 10 years prior. Her medications were prednisolone (1 mg/d) and levothyroxine.
Please finish quiz first before checking answer.
Read the answer below and download your certificate.
Read the discussion below and retake the quiz.
Sign in to take quiz and track your certificates
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Mitsuyo Kinjo, MD, MPH, Department of Medicine, Okinawa Chubu Hospital, 281 Miyasato, Uruma 9042293, Japan (email@example.com).
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient’s daughter for granting permission to publish this information. We also thank Lisa Rucker, MD, MS (Department of General Internal Medicine, Jacobi Medical Center, New York), and Rita McGill, MD, MS (Department of Nephrology, University of Chicago), for English correction of the manuscript.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
You currently have no searches saved.
You currently have no courses saved.