Saturday, April 2, 2016

A 6 Year Old Child Presents With A Skin Erruption

This 6 year old child initially had a solitary oval patch on his trunk which was treated by the general practitioner with clotrimazole lotion considering it to be tinea corporis lesion. But after 5-7 days the eruption began to spread and affected mainly the trunk, back and proximal parts of upper limbs. It was associated with mild itching.The picture in closeup is shown below:

1. What is the most probable diagnosis?
2. What was that initial solitary lesion?
3. What are salient features of this eruption?
4. How long does this disease last?
5. How one should manage it?

Answers And Discussion:

A Case Of Partial Albinism (Piebaldism)

This neonate has a white forelock of hairs and patch of hypopigmentation on forehead. There are no other anomalies seen.

What is the most likely diagnosis?

Answer With Discussion: If only a patch of hypopigmentation on skin of forehead and white forelock
of hairs was present then it is suggestive of Partial Albinism also known as Piebaldism.

Friday, March 25, 2016

A Case Of Hammar -Toe Deformity

A 47-year-old woman presented with pain in the ball of her feet on weight-bearing. She works as a nurse and walks most of her 12-hour shift. Few months ago she noticed deformity of the digits in her feet. On examination it was noticed that her deformed digits are contracted with a nonreducible proximal interphalangeal joint and reducible metatarsophalangeal (MTP) joint. The picture is shown above. She was referred to a podiatrist who diagnosed hammer-toe deformity.

Case Discussion:
Hammar-Toe Deformity:

Friday, March 11, 2016

Management Of A Patient With An Ischemic Stroke

A 68-year-old man with a history of hypertension and coronary artery disease presents with right sided weakness, sensory loss, and an expressive aphasia. Neuroimaging studies are shown.

In the emergency department the patient’s blood pressure is persistently 160/95.

Which of the following is the best next step in management of this patient’s blood pressure?

a. Administer IV nitroprusside.
b. Administer oral clonidine 0.1 mg po until the blood pressure drops below 140/90.
c. Observe the blood pressure.
d. Administer IV mannitol.
e. Administer IV labetolol.

Answer And Discussion:

A 42 Year Old Alcoholic Man Presents With Cough And Fever

A 42-year-old alcoholic man develops cough and fever. Chest x-ray is shown below which shows an air-fluid level in the superior segment of the right lower lobe.

Which of the following is the most likely etiologic agent?

a. Streptococcus pneumoniae
b. Haemophilus influenzae
c. Legionella pneumophila
d. Anaerobes
e. Mycoplasma pneumoniae

Answer And Discussion: