Gradual subungual discoloration; benign paroxysmal vertigo; thrush in HIV infection; paralyzed phrenic nerve: see if you can answer this week's 5 quiz questions.
A 49-year-old woman noted the gradual onset of reddish blue discoloration under one fingernail. There was both spontaneous pain and tenderness to palpation.
For the past few months, a 2 1/2-year-old boy seems to suddenly lose his balance periodically. The history points to a diagnosis of benign paroxysmal vertigo.
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A 24-year-old woman presents for evaluation of a pigmented area on her face, present since birth. The diagnosis was nevus of Ota.
A 71-year-old man was referred for evaluation of the sudden onset of exertional dyspnea. He reported shortness of breath when supine and an occasional cough with no sputum. A chest film showed an elevated right hemidiaphragm, which was confirmed by CT scan. This raised the possibility of right phrenic nerve paralysis as the cause of his symptoms.
Question 1. Answer: a
Question 2. Answer: c
Question 3. Answer: b
Question 4. Answer: a
Question 5. Answer: d