Go For the Glory Quiz: Persistent Head/Neck Pain; Lower Extremity Discomfort; Friable Papule; Unexplained Facial Pimples

May 3, 2013

Test your clinical skills in this week’s 5-question quiz.

QUESTION 1:



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A 29-year-old man presented with a 4-year history of headache and severe neck pain. The neck pain is constant, dull, and achy; radiates up to the posterior scalp and down both shoulders; and is sometimes accompanied by occipital headaches. He noted that the headaches and neck pain increase in intensity with coughing, lifting, or exercising. A cervical MRI scan without contrast was obtained.

QUESTION 2:

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A 58-year-old man presents with tingling, numbness, and mild burning in his lower legs. He denies any visual changes, dizziness, weakness, fatigue, chest pain, shortness of breath, or abdominal discomfort. He does not smoke and drinks alcohol socially. The patient has had hypertension for 15 years, his triglyceride level is high, and his fasting glucose level is 102 mg/dL. He is 5 ft 7 in tall, weighs 192 lb; his waist measurement is 40 in

QUESTION 3:



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A 53-year-old woman felt the underwire in her bra stab the inframammary skin. She covered the wound with antibiotic ointment under a bandage. The wound was slow to heal, and was ultimately replaced by a friable, oozing papule.

QUESTION 4:



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A 26-year-old African American woman presents for help with “pimples” on both sides of the nose. She is healthy and takes no medications. Review of systems was entirely negative.

QUESTION 5:



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4. A 26-year-old man presented to the emergency department with progressively worsening generalized fatigue and weakness that had been present for the past few months. Findings from the patient’s history and physical examination were unremarkable. A family history was notable for colon cancer in his father and grandfather. Results of laboratory studies were significant for iron deficiency anemia. Colonoscopy revealed innumerable polyps carpeting the mucosa from the rectum to the cecum. A diagnosis of familial adenomatous polyposis (FAP) was made.

ANSWER KEY:



Question 1. Answer: a

Question 2. Answer: c

Question 3. Answer: d

Question 4. Answer: a

Question 5. Answer: e