Answer of the image challenge C - Cocaine

Why?

Perforation of the nasal septum and palate are well recognized complications of intranasal cocaine use.

Source: The New England Journal of Medicine

Which one of the following drugs of abuse is most typically associated with the illustrated complication?

A- Ketamine

B- Heroin

C- Cocaine

D- Phencyclidine

E- Mescaline

Chose your answer?

Answer of the image challenge A- Palsy of the long thoracic nerve

Why?

Weakness or paralysis of the serratus anterior due to palsy of the long thoracic nerve is a common cause of a winged scapula.

Source: New England Journal of Medicine

This 9-year-old boy presented with a two-day history of right shoulder pain after an upper respiratory tract infection. What is the cause of the abnormality demonstrated?

A- Palsy of the long thoracic nerve

B- Subcutaneous emphysema

C- Neuralgic amyotrophy

D- Pleural prolapse

E- Scapular subluxation

Chose your answer?

Source: New England Journal of Medicine

What endocrine diagnosis is affecting the identical twin on the right side of the image?

A- Acromegaly

B- Addison’s disease

C- Cushing’s syndrome

D- Hypogonadism

E- Hypothyroidism

Chose your answer?

Source: New England Journal of Medicine

What is the most likely diagnosis?

A- Alport syndrome

B- Angelman syndrome

C- Fragile X syndrome

D- Turner syndrome

E- Williams syndrome

Chose your answer?

The correct answer is letter E- Right sixth cranial nerve palsy.

Why?

The neurologic examination reveals an inability to abduct the right eye with horizontal gaze to the right, a finding that is consistent with an isolated right abducens nerve palsy.

Source: New England Journal of Medicine

This patient was trying to look right when the image was taken. What is the diagnosis?

A- Internuclear ophthalmoplegia

B- Left fourth cranial nerve palsy

C- Left sixth cranial nerve palsy

D- Right fourth cranial nerve palsy

E- Right sixth cranial nerve palsy

Chose your answer?

Source: New England Journal of Medicine

In what vessel is this patient’s dialysis catheter?

A- Left axillary vein

B- Left internal mammary vein

C- Left-sided superior vena cava

D- Azygous vein

E- Higher intercostal vein

Chose your answer?

What is the diagnosis?

A- Subcutaneous Metastases

B- Filariasis

C- Caput Medusae

D- Neurofibromatosis

E- Hepatocellular Carcinoma

Chose your answer?

Source: New England Journal of Medicine

?

This patient presented with unilateral rhinorrhea. What is the diagnosis?

A- Nasal foreign body

B- Osteoma

C- Pituitary tumor

D- Skull fracture

E- Sinusitis

Chose your answer?

Source: New England Journal of Medicine

?

Every day I’m going to choose a image challenge for you guys… You will have one day to answer, so then I’ll put the correct answer and an article about the topic of the challenge…
And all the credits go to NEJM - New England journal of medicine.
So here comes the first…

Which one of the following conditions is the most likely to be responsible for this clinical picture?

A- Excessive fluoride supplementation

B- Hyperbilirubinemia

C- Treatment with tetracycline

D- Trichophyton rubrum infection

E- Pseudomonas aeruginosa infection

Chose your answer?