I AM A LOOKING TO GO

A prescription for pain

Figure 1 Quiz of the Week A 70-year-old male with a history of hypertension presents with a fever and severe pain in both his hands. Examination reveals swollen, erythematous, and tender nodules on the joints of his fingers. Arthrocentesis demonstrates negatively birefringent urate crystals in the synovial fluid.    Image credit: @drugpiter, @twcc.   Answer: Precocious…

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…