Go For The Glory Quiz: Melanoma? Löfgren syndrome; Atrial Fibrillation; Altered Mental Status

March 7, 2013

Does this look like melanoma? Which is not true of Löfgren syndrome? Yoga and Afib; what cause of mental confusion? Skin lesions and HIV.. . . See if you can answer this week's quiz questions.

QUESTION 1:



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A 69-year-old homosexual man complained about an asymptomatic “dark spot” on his cheek. The lesion had been present at least 6 months. His medical history included rare actinic keratoses.

QUESTION 2:



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Lfgren syndrome is a form of acute sarcoidosis characterized by a triad of symptoms: hilar adenopathy, erythema nodosum, and arthralgias.

QUESTION 3:

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QUESTION 4:

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A 54-year-old woman had altered mental status and confusion of 2 days’ duration. She had been receiving chemotherapy for 5 months for metastatic pancreatic adenocarcinoma. Other relevant medical history included deep venous thrombosis, anemia, chronic hyponatremia, osteoporosis, irritable bowel syndrome, and seasonal allergies. She did not use tobacco, alcohol, or illicit substances. Cranial nerve function was intact but ocular examination revealed bilateral horizontal nystagmus. An MRI study of the brain revealed abnormal signaling in the periaqueductal gray matter.

QUESTION 5:



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A 38-year-old homosexual man presented with cough and multiple asymptomatic lesions on his face. A chest film was positive for nodular parenchymal infiltrates, most consistent with an infection from either acid-fast bacilli or fungi. Laboratory tests revealed a positive HIV serology and gross lymphopenia.

ANSWER KEY:



Question 1. Answer: c

Question 2. Answer: a

Question 3. Answer: b

Question 4. Answer: b

Question 5. Answer: c