Answer: Image Challenge What term is used to describe this finding? Q: 1. Hyphema Layering of blood in the anterior segment is termed hyphema. Hypopyon refers to pus in the anterior segment. Iridocyclitis refers to inflammation of the iris. Iridodonesis is a quivering of the iris when the patient moves the eye. Synechia is an adhesion between the iris and the lens. Read More: N Engl J Med 2008;358:2265
Answer: Image Challenge What is the diagnosis? Q: 5. Keratoderma blennorrhagicum These vesiculopustular waxy lesions are most consistent with keratoderma blennorrhagicum. This finding should prompt diagnostic testing for sexually transmitted or gastrointestinal pathogens. Read More: N Engl J Med 2008;358:2160
This rash appeared following treatment for leukemia. What is the diagnosis?
2. Leukemia cutis
3. Herpes zoster
4. Graft-versus-host disease
5. Urticaria pigmentosa
Answer: Image Challenge This rash appeared following treatment for leukemia. What is the diagnosis? Q: 4. Graft-versus-host disease There is hyperpigmentation and hypopigmentation of the skin, cutaneous atrophy, telangiectasia, and ulcerations. This is most consistent with graft-versus-host disease of the skin.
Treatment with which one of the following medications is associated with this clinical finding?
Answer: Image Challenge Treatment with which one of the following medications is associated with this clinical finding? Q: 1. Erlotinib Erlotinib, a tyrosine kinase inhibitor of the epidermal growth factor receptor, induces characteristic hair alterations. Trichomegaly, curling, elongation, and trichorrhexis are typical; these reverse after discontinuation of therapy. The pictured changes are not typical of leflunomide, methotrexate, pegvisomant, or psoralen. Read More: N Engl J Med 2008;358:1175
Answer: Image Challenge What is the diagnosis? Q: 5. Mandibular fracture This patient developed a comminuted fracture of the left and right mandible after being struck on his right lower jaw. The open fracture allowed upward displacement of the left half of the mandible. Read More: N Engl J Med 2008;358:512
80s Flashback! What was Madonna’s first #1 hit?
Gen: Agitated and lying in bed. Opens eyes to voice intermittently. Tremulous and diaphoretic.
HEENT: Normocephalic and atraumatic. PERRL. Pt will not cooperate with opening mouth for OP exam.
Neck: No masses. Trachea midline. Carotids 2+
Lungs: CTA bil, no wheezing or rales
CV: Tachycardic, regular. S1 and S2 normal, no m/r/g
Abd: soft/nt/nd. Bowel sounds normal to hyperactive.
Ext: 1-2+ pitting edema in RLE. LLE without edema. Right hip surgical site is c/d/I with mild serosanginous drainage. DP and PT pulses 2/2.
Neuro: Not able to follow commands. Opens eyes to pain, voice and touch. Visible tremors in bil lower extremities. Spontaneous clonus in RLE, inducible clonus with multiple beats in bil LE, but R>L. Patellar reflexes 3+ bilateral. Biceps reflexes 2-3+ bil. Bil LE exhibit rigidity bilaterally. Unable to illicit babinski sign due to rigiditiy.