Cough and Subungual Lesions

January 30, 2015

Is there a connection between this patient’s symptoms and the thin red-brown lines under his nails? Answer this question and 4 others in this quiz.

 

Question 1:

A 42-year-old man presents with nonproductive cough and subjective fevers and chills with associated arthralgias of 2 weeks’ duration. Cardiopulmonary examination reveals clear lungs, with a grade II/VI systolic ejection murmur. The rest of his physical exam is unremarkable except for some lesions under the fingernails.

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The correct answer is b. Endocarditis.
For a discussion of the case, click here.

 

Question 2:

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The correct answer is c. Coronary angiography.
For a discussion of the case, click here.

 

Question 3:

A 36-year-old man presents with the new onset of stinging and burning well-defined whitish plaques randomly scattered on the dorsum of the tongue.

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The correct answer is c. Lichen planus.
For a discussion of the case, click here.

 

Question 4:

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The correct answer is b. False.
For a discussion of the case, click here.

 

Question 5:

A 48-year-old man with chest pain and hematemesis and a history of hiatal hernia, acid reflux, and a single esophageal dilatation 15 years ago was found to have pneumomediastinum.

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The correct answer is a. Boerhaave syndrome. For a discussion of the case, click here.