3. 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
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5. 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
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7. 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.
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9. 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
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11. 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
23. How does serotonin syndrome effect you? On that note… DON’T FORGET TO LOG YOUR WORK HOURS!
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Editor's Notes
Diagnosis largely clinical but can use labs to narrow the differential. Diagnosed based on clinical findings; Hunter Diagnostic Toxicity Criteria Rules.
Cyprohepatdine is a histamine-1 antagonist with nonspecific 5-HT1A and 5-HT2-A antagonist properties. Definitive evidence is lacking.
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