Clinical

Failure to thrive in a child—what’s the cause?

Figure 1 Quiz of the Week A three-year-old African American boy is brought to his new pediatrician over concerns of poor growth, fatigue, and irritability. On examination, he has a large head and generalized muscular hypotonia. His left wrist demonstrates the findings seen here.  Image credit: @Danflanders.   Answer: Nutrition counseling This patient’s clinical presentation is consistent...

Neck pain, headache, and dysdiadochokinesia—what’s the cause?

Figure 1 Quiz of the Week A 28-year-old female presents to the emergency department with an occipital headache and neck pain. She mentions her symptoms appeared after hyperextending her neck while playing tennis the day before. Examination reveals dysdiadochokinesia and decreased lateral vision. A contrast head and neck CT demonstrate the findings seen here.  Image...

Macroglossia and edema—what do you suspect

Figure 1 Quiz of the Week A 65-year-old male presents to his family physician with complaints of increasing fatigue, dyspnea on exertion, and unintentional weight loss within the last six months. On examination, he is noted to have macroglossia and peripheral edema. Crackles are audible bilaterally on chest auscultation. Image credit: @nikhilchadha.   Answer: Bone marrow...

Why is this urine bag purple?

Figure 1 Quiz of the Week An 80-year-old female with a history of diabetes and chronic constipation presents to the emergency department with a purple urine bag. She is currently bedridden and uses an indwelling catheter. On examination, she is hypotensive and confused. Blood cultures are positive for Proteus vulgaris. Image credit: @ctip.   Answer: Ciprofloxacin...