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Go For The Glory Quiz: Livedo Reticularis; Persistent Fatigue; Groin Rash; Paraneoplastic Syndrome; and, a "Funny" Mole.


Livedo reticularis; persistent fatigue and weight gain; groin rash; paraneoplastic syndrome; funny mole.


A 62-year-old woman was evaluated in preparation for cholecystectomy. She had no cardiac or pulmonary disorders. The physical examination was unremarkable other than a purplish red lace-like pattern on the skin. Livedo reticularis was diagnosed.


A 34-year-old woman has fatigue that has come on gradually over the past 6 months, accompanied by a 5-lb weight gain. She had a viral syndrome 4 months earlier and had nodular sclerosing Hodgkin disease 4 years ago. The Hodgkin disease was limited to the chest and was treated with radiation and chemotherapy; 8 months ago, there was no evidence of the disease. Blood pressure is 125/90 mm Hg; heart rate, 65 beats/min, and temperature, 36°C (97.4°F). The WBC count is 4500/μL, hemoglobin level is 11.2 g/dL, and platelet count is normal.


 An older, obese, diabetic patient presents with intense itching and burning in the groin and on the scrotum.


For the discussion, click here.Click here for the next question.For the answers, click here.

A 71-year-old man with fatigue, malaise, dizziness, syncope, and progressive weakness was transferred to the medical intensive care unit from another facility for weaning from mechanical ventilation. A chest film showed a mass in the right lung field. Bronchoscopic biopsy revealed limited-stage small-cell lung cancer (SCLC). The patient received one cycle of chemotherapy with cisplatin and etoposide. Assays of serum and cerebrospinal fluid were mildly positive for anti-Hu antibody. The patient was found to have paraneoplastic syndrome associated with SCLC and the presence of anti-Hu antibody.


A 52-year-old man complains that his mole on his flank, present since birth, is “doing funny things.” In the center of this long-standing lesion is an exophytic, friable but hard, nodule.


Question 1. Answer: a

Question 2. Answer: b

Question 3. Answer: b

Question 4. Answer: c

Question 5. Answer: c


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