The Medical Joyworks Monthly


Connect to MJ's thriving community

Issue #7 (April 2020)


The latest from MJ

  • Whether you're a part of your community's response to the COVID-19 pandemic, or are trying to maintain some semblance of a normal life, know that you're not alone. We share your struggle, and wish that you and your loved ones stay healthy and safe.
  • Many of our writers and IMB members are responding to the emergency, and this has slowed our ability to regularly deliver quality content. Therefore, we've reduced the number of learning modules released in our apps each month.
  • Despite these challenges, we've been busy helping universities and professional associations with their sudden distance-learning needs. Clinical Sense: University Edition (CSU) is proving to be an ideal tool for physicians and students who must continue developing their clinical skills from home, while staying engaged with instructors and peers.
  • If CSU can help you, please let us know! We'll ensure that the setup and cost is within what your community can manage at this time. For more details, visit:


Q&As from our user community

Clinical Sense: Unexpected (Acute Myeloid Leukemia in Pregnancy)

Q: This pregnant patient will be started on chemotherapy. Isn't there a risk to the fetus?
A: The patient in this scenario is in her second trimester. The risk of fetal cytotoxicity is markedly reduced in the second and third trimesters, as compared to the first trimester. She can be started on induction therapy, with regular fetal surveillance.

Please see: 
If you would like to play this scenario or join the conversation, go to the Clinical Sense app in your mobile device.

Prognosis: Your Diagnosis: More headaches (Subarachnoid Hemorrhage)

Q: This patient had a subarachnoid hemorrhage (SAH). Why did you perform a lumbar puncture (LP)?
A: In this case, computed tomography (CT) did not detect a SAH. However, given the suggestive history, normal fundoscopy, and lack of mass lesions in the CT, a LP was a reasonable next step in establishing if a SAH had occurred. LP was also useful for excluding or establishing other differential diagnoses.

Note that where available, CT angiography is an alternative to LP, albeit with certain drawbacks. Furthermore, if this patient had presented within the first 6 hours of symptom onset, a negative CT would have definitively excluded SAH.

Please see: and
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.


Recently released stories

Clinical Sense

Yellow (updated)
With age (updated)
That's all for now!

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