Classic Presentations part 2

Question 1

Strawberry tongue

Answer 1

Scarlet fever, Kawasaki disease

Question 2

Abdominal pain, diarrhea, leukocytosis, recent antibiotic use

Answer 2

Clostridium difficile infection

Question 3

Back pain, fever, night sweats

Answer 3

Pott disease (vertebral TB)

Question 4

Adrenal Hemorrhage, hypotension, DIC

Answer 4

Waterhouse-Friderichsen syndrome (meningococcemia)

Question 5

Red “currant jelly” sputum in alcoholic or diabetic patients

Answer 5

Klebsiella pneumoniae pneumonia

Question 6

Large rash with bullseye appearance

Answer 6

Erythema migrans from Ixodes tick bite (Lyme disease: Borrelia)

Question 7

Ulcerated genital lesion

Answer 7

Nonpainful, indurated: chancre (1° syphilis, Treponema pallidum)

Painful, with exudate: chancroid (Haemophilus ducreyi)

Question 8

Pupil accommodates but doesn’t react

Answer 8

Neurosyphilis (Argyll Robertson pupil)

Question 9

Smooth, moist, painless, wart-like white lesions on genitals

Answer 9

Condyloma lata (2° syphilis)

Question 10

Fever, chills, headache, myalgia following antibiotic treatment for syphilis

Answer 10

Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in endotoxin-like release)

Question 11

Dog or cat bite resulting in infection

Answer 11

Pasteurella multocida (cellulitis at inoculation site)

Question 12

Black eschar on face of patient with diabetic ketoacidosis

Answer 12

Mucor or Rhizopus fungal infection

Question 13

Rash on palms and soles

Answer 13

Coxsackie A, 2° syphilis, Rocky mountain spotted fever

Question 14

Chorioretinitis, hydrocephalus, intracranial calcifications

Answer 14

Congenital toxoplasmosis

Question 15

Child with fever later develops a red rash on face that spreads to body

Answer 15

Erythema infectiosum/fifth disease (slapped cheeks appearance, caused by parvovirus B19)

Question 16

Fever, cough, conjunctivitis coryza, diffuse rash

Answer 16

Measles

Question 17

Small, irregular red spots on buccal/lingual mucosa with blue-white centers

Answer 17

Koplik spots (measles (rubeola) virus)