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Weekly News Quiz

Make the Diagnosis: At Least this Groom Doesn’t have Cold Feet

Just a few days after returning from his honeymoon at a Brazilian beach resort, a 29-year-old man went to his primary care doctor complaining of extremely pruritic toes and feet. After he started scratching, he noticed some small black dots, umbilicated papules, and crusts on the soles and at the tip of his toes under the nail. He had been finding it uncomfortable to walk since the last day of the trip. Can you diagnose the patient?
May 25, 2018

Make the Diagnosis: More Than a Mosquito Bite

Case Findings: A 52-year-old man who had returned from an end-of-summer camping trip in Vermont two weeks earlier went to the doctor complaining of a severe headache in the front of his head and a widespread rash of blanching macules. The illness had started a few days earlier with just a mild fever, myalgias, and some loss of appetite. Despite feeling terrible, he joked that his trip was fun, but he's pretty sure the mosquito is the unofficial bird of Vermont. What is your diagnosis?
Sep 29, 2017

Make the Diagnosis: Rare Affair of Scalp Hair

The mother of a 7-year-old boy asked about a patch of unruly hair on the occipital area of her son's head. Until about 9 months ago he had always had a very short haircut, but now that he wanted to grow his hair longer, they noticed that this area always seemed very kinky, a little bit lighter in color, more fragile, and easily tangled. At first his mother thought it was because he didn't comb it before bedtime, but no amount of care made a difference. No one else in the family had very curly hair or a similar patch of hair, and he was otherwise healthy.
Aug 28, 2017

Make the Diagnosis: A Toddler with Swollen Eyelids

Case Findings: A 4 year old male child is brought to your office by his mother who notes that his right eyelids have seemed red and swollen for the past 24 hours. She says that the child was outside playing in the backyard yesterday and thinks he was stung by a bee over the right upper eyelid. The redness and swelling began soon after. Although the child is in some discomfort, he seems otherwise well and is afebrile. On examination there is mild-moderate edema of the upper and lower eyelids but no apparent proptosis. Visual acuity is 20/20 bilaterally with normal extraocular movements, pupillary responses, and IOPs. What is the most likely diagnosis?
Jun 19, 2017

Make the Diagnosis: Baffling Bruises

Case Findings: A 17-year-old girl went to her primary care physician complaining of easy bruising, especially on her legs. She couldn't recall having any injuries, even minor bumps, that might have caused the red and purple ecchymoses that had appeared. She insisted that no one else had caused her harm. She also complained of headache and nausea. She was about to complete her final exams and was concerned she would have bruises on her legs during graduation. What is your diagnosis?
Jun 27, 2016

Make the Diagnosis: Sickle Cell Stumper

Case Findings: A 26-year-old African American female with sickle cell anemia presents to the hospital with chest pain and shortness of breath. She has been transfused 3 units of packed red blood cells within the last 3 months at another institution. Preliminary testing in the blood bank indicate the following: ABO/Rh: A Rh-positive, Direct antiglobulin test: positive; IgG, and antibody screening test shows Cell I IAT: 2+, Cell II IAT: 3+, Cell III IAT: 2+. The initial antibody panel is done and shown below (Image A). The blood bank technician performs an alloadsorption to look for any underlying alloantibodies (Image B). What is your diagnosis after reviewing the panels?
Jun 14, 2016

Make the Diagnosis: Back Lesion Worries Derm's Wife

A middle-aged couple comes into your office. The wife is concerned about a strange looking growth on her husbands upper back that she feels has been stable for the past two years. She tells you that her husband is a dermatologist, but rarely uses sunscreen despite all the advice he gives his patients. The husband tells you that he would like to be a back model again someday if you could just get rid of this growth. What's your diagnosis?
Dec 22, 2014

Make the Diagnosis: Small papule

While performing a physical exam during a routine wellness visit, you discover a single papule on the upper back of your 59 year old fair-skinned patient. On closer examination of the lesion, you note that the papule appears to have an almost translucent surface and small visible blood vessels are seen within the lesion. You also note what appears to be the beginning stage of an ulcer in the center of the lesion. You inform your patient that you need to perform a biopsy to confirm your diagnosis. What is your diagnosis?
Oct 06, 2014

Make the Diagnosis: Why Did This Toddler Stop Walking?

Case Study: A fourteen-month-old boy had abruptly stopped bearing weight on his left lower extremity. Parents reported no history of trauma to the limb, but the boy’s medical history included undescended testes. On presentation, the patient had a fever of 100.4°F, which rose to 101.5°F He held his left leg externally rotated and flexed at the hip and refused to extend or bear weight on the limb or crawl. The left hip was tender, but without any palpable masses. He showed minimal signs of discomfort with passive rotation and axial loading. The passive range of motion of the hip showed limitations in extension and adduction.
Aug 27, 2014
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