Clinical

What’s causing this patient’s spontaneous laughter?

Figure 1 Quiz of the Week A 45-year-old female presents with painful lesions on her lower limbs and ears. She is a smoker, and has a history of recreational drug use. Purpuric, necrotic lesions are noted on both lower extremities, in addition to tender purpura on both ears. A biopsy is performed which demonstrates leukocytoclastic...

What substance is associated with this presentation?

Figure 1 Quiz of the Week A 45-year-old female presents with painful lesions on her lower limbs and ears. She is a smoker, and has a history of recreational drug use. Purpuric, necrotic lesions are noted on both lower extremities, in addition to tender purpura on both ears. A biopsy is performed which demonstrates leukocytoclastic...

Cough, conjunctivitis, and coryza — what’s the cause?

Figure 1 Quiz of the Week A five-year-old male with a four-day history of fever presents with a new erythematous rash. His mother says he has been coughing and sneezing for the past few days. Examination reveals conjunctivitis, grayish elevations on the buccal mucosa opposite his molar teeth, and a maculopapular rash on his trunk...

How would you manage this acute abdominal pain?

Figure 1 Quiz of the Week A 24-year-old sexually active female presents with a three-day history of severe right upper quadrant pain that worsens on inhalation. She has a history of multiple sexual partners and does not use contraception. Examination reveals marked tenderness in the right upper quadrant and laparoscopy demonstrates the findings seen here....