The Unlabeled Spectrum

Sean and Lauren discuss a difficult patient in a quiet Seattle hospital consultation room.

The Unlabeled Spectrum

Listen and choose the right answer

What is Lauren's primary concern regarding the patient's condition?

• Whether it is one overlap syndrome or three separate diseases
• Whether the patient can afford expensive biologic treatments
• Whether the hospital ethics committee will approve surgery

What diagnostic material had nobody requested until Sean intervened?

• The recent genetic sequencing panel from Boston
• The old biopsy slides from twenty years ago in Denver
• The outpatient toxicology screening reports

What rare condition did the archived slides ultimately reveal?

• Castleman disease
• IgG4-related disease
• Erdheim-Chester disease

What do the physicians decide to do at the end of the conversation?

• Draft an original research article for a high-impact journal
• Transfer the patient to a clinic in London
• Order a brand new invasive repeat biopsy immediately

Listen again and complete the sentences

• Lauren: Sean, what worries me is whether we're dealing with three separate autoimmune conditions or just one massive ____ .
• Sean: I've been reviewing her chart all morning, and to be honest, her ____ completely defies Occam's razor.
• Lauren: Exactly. When pulmonary fibrosis, nephritis, and skin lesions coexist, we usually fall back on ____ .
• Sean: That said, what we need here isn't another provisional label, but a solid ____ from a repeat biopsy.
• Lauren: That's incredible! Let's put them under the double microscope right now and see what ____ markers show up.

Sources: photo by Edward Jenner on Pexels