Hypereosinophilic Syndrome; Pneumonia; Necrobiosis Lipoidica: A Photo Quiz

May 29, 2014

Four photos, 5 questions: see how accurately you can answer our quiz questions that include pulmonary embolism and invasive squamous cell carcinoma of the lung.

Question 1:

Hypereosinophilic syndrome was diagnosed in a 45-year-old man with a 3-week history of increasing abdominal girth and diffuse abdominal pain.

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Question 2:

A 9-year-old girl with a transesophageal fistula that was diagnosed in utero has had recurrent bouts of pneumonia. A chest film showed a significant pneumomediastinum. The patient denied chest pain and dyspnea, and she remained normoxic. The pneumomediastinum resolved within about 30 minutes.

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Question 3:

 

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Question 4:

These yellowish, firm plaques with large telangiectasia coursing over the top with no associated scaling are typical of necrobiosis lipoidica. Here they are shown on the foot of a 34-year-old morbidly obese man. His fasting blood sugar level was 250 mg/dL and his hemoglobin A1c level was 8.8%.

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Question 5:

A 60-year-old Caucasian man with a history of invasive squamous cell carcinoma of the lung presents with these lesions.

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ANSWER KEY:

Question 1. C

Question 2. B

Question 3. B

Question 4. E

Question 5. C