Mark P. Brady, MS, PA-C

Headache and nausea have bothered this 28-year-old for 3 days. Over-the-counter analgesics do not help. She reports the headache lessens during the day. What more do you need to know?

These presenting symptoms began after a near syncopal episode. The patient has no significant medical or surgical history. More details, here.

Small and nondescript, subungual splinter hemorrhages should prompt further investigation.

Thin dark lines beneath the fingernails are the only physical findings of note in a middle-aged man who presents with cough, fevers, and arthralgias.

The young athlete is otherwise healthy but his ECG tracing and family history may suggest a different story.

A 22-year-old young woman presents with complaints of severe pain in all the toes on both feet. She reported going hiking when the daytime temperature unexpectedly dropped. She describes persistent pain and mild pruritus in her toes. What is the diagnosis?   

Chilblains (Pernio) is typically caused by an abnormal vascular response to non-freezing cold exposure.

Black hairy tongue is benign and self-limited. It is caused by abnormal hypertrophy and elongation of filiform lingual papillae with associated discoloration.

Black hairy tongue is characterized by an abnormal hypertrophy and elongation of filiform lingual papillae with an associated “brown” or “black” discoloration.