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Quizzes and Polls

Latest Quiz

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May 21, 2013

Sudden Purpuriform Rash in an Infant

A 10-month-old boy presents with erythematous swelling of both ears and right eyelid and erythematous perioral macules following a respiratory infection.

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Test your knowledge with previous versions of the JAMA Clinical Challenge.
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April 30, 2013

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April 30, 2013

Abdominal Swelling in a Teenaged Girl

A 16-year-old girl with 3 months of abdominal pain and swelling that increase after eating reports increased urinary frequency and slight weight gain but is not pregnant or bulimic.

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April 16, 2013

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April 16, 2013

Edematous Erythema, Subcutaneous Plaques, and Severe Pain in the Lower Extremities in an Immunocompromised Patient

A woman with a renal transplant for 10 years is admitted for lower-extremity edematous erythema, subcutaneous plaques, and severe pain. Three courses of intravenous antibiotics have not dissipated her fever. Blood cultures are negative.

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March 26, 2013

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March 26, 2013

Cervicodorsal Lipodystrophy (Buffalo Hump)

A 51-year-old man with a history of HIV and currently taking abacivir/lamivudine/zidovudine presents with a cervical lipodystrophy.

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March 12, 2013

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March 12, 2013

Chest Pain and an Angiographic Abnormality

A 55-year-old man is admitted from the emergency department with 1 month of progressively worsening dyspnea and exertional angina.

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February 26, 2013

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February 26, 2013

Acute Onset of Retrosternal and Epigastric Pain

A 15-year-old boy presents to the emergency department with acute onset of severe pleuritic retrosternal and epigastric pain after swallowing a mouthful of cold soda.

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February 12, 2013

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February 12, 2013

Unilateral Proptosis

A 40-year-old man has a 2-month history of left periorbital swelling and pain without trauma, fever, or recent sinusitis. Examination reveals chemosis and proptosis. Neurological examination and laboratory studies are unremarkable.

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January 22/29, 2013

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January 22/29, 2013

Hypopigmented Patches on the Skin

A 47-year-old man with a mildly pruritic eruption on his trunk and extremities has hypopigmented round patches with fine cigarette-paper scaling on his arms, hips, thighs, lateral chest wall, and flanks. His skin scrapings are negative for hyphae and he has no palpable lymphadenopathy.

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January 8, 2013

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January 8, 2013

Diffuse Calcification and a Draining Wound

A 46-year-old man admitted because of dyspnea and altered sensorium and who was receiving chronic hemodialysis was noted to have “milky” secretions draining from a hip wound. A hip radiograph showed bulky, extra-articular calcifications.

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December 25, 2012

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December 25, 2012

Upper Body Papules and Recurrent Pneumothorax

A 31-year-old woman presents with a 10-year history of facial and upper body papules, confirmed as fibrofolliculomas, a condition she shares with her immediate family. Her father also has a history of recurrent pneumothorax.

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December 11, 2012

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December 11, 2012

Antibiotic Refractory Sinusitis

A man with a history of chronic sinusitis presented with unilateral periorbital swelling and subtle ptosis. Symptomatic improvement followed antibiotic treatment for presumed sinusitis, but within 1 month, increased periorbital swelling and persistent ptosis were noted.

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November 27, 2012

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November 27, 2012

Neck Mass in a Returning Traveler

Three months after travel in Asia and the Middle East, a patient with diabetes had a painful, fluctuant neck mass. Outpatient incision and drainage were scheduled and empiric oral clindamycin initiated. Eight days later he returned with worsening neck pain.

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November 13, 2012

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November 13, 2012

A Right Wrist Lump

A patient with a 30-year history of an enlarging, painless wrist mass has functional limitation. Ultrasound examination shows a cystic-appearing mass with no arterialized flow and angiography reveals delayed contrast enhancement.

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October 23, 2012

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October 23, 2012

Multiple Cutaneous Swellings Associated With Sudden Collapse

A 77-year-old man without trauma or back pain or bowel, bladder, or radicular symptoms develops an acute inability to walk and presents with multiple upper body blue-black cutaneous swellings. Bilateral leg weakness develops.

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October 9, 2012

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October 9, 2012

Familial History of Bone Tumors

A 61-year-old man presents with progressive chronic pain in his lower extremities and episodes of dysthesia. Examination shows that he has bony masses on both legs.

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September 25, 2012

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September 25, 2012

A Florid, Tiny, Discrete Eruption on the Penis

A 13-year-old presents with asymptomatic papules on his penis and reports no other symptoms or sexual activity.

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September 11, 2012

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September 11, 2012

Short Fourth and Fifth Metacarpals

A 9-year-old has uncontrolled seizures since age 7 months, brachydactyly, and x-ray evidence of fourth and fifth metacarpal shortening.

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August 21, 2012

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August 21, 2012

Cutaneous Nodule in a Young Man

A 21-year-old man presents with an enlarging nodule on his chest, upper abdominal pain, diarrhea, and recent weight loss.

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August 14, 2012

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August 14, 2012

Ocular Trauma

A 35-year-old man presents to the emergency department (ED) with painful vision loss, tearing, and photophobia after being struck in the left eye by a plastic pole 3 days earlier.

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August 7, 2012

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August 7, 2012

Silvery-Gray Hair in a Newborn

A term newborn, born via spontaneous vaginal delivery, had abnormally light skin and silvery hair that is dark at the roots and light at the tips.

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July 22, 2012

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July 22, 2012

A Crusted Plaque on the Right Nipple

A healthy heterosexual man presents with a crusted plaque on his nipple, which formed after a bite during sexual intercourse, and a generalized macular rash.

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July 10, 2012

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July 10, 2012

A Pain in the Neck

A 68-year-old woman with small cell lung cancer has a bulging area behind her ear. She previously had resection and radiation therapy for a recurrent hemangioblastoma.

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June 26, 2012

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June 26, 2012

A Violaceous Plaque in an Immunosuppressed Patient

A 56-year-old man with acute myelogenous leukemia with complications of neutropenia and fever of unknown origin developed a violaceous plaque on his neck.

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June 12, 2012

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June 12, 2012

A Young Patient With Persistent Gingival Bleeding

A 13-year-old girl who practices good oral hygiene is seen for evaluation of oral ulcers, gum erythema, and a "peeling off" sensation in her gums.

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May 22, 2012

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May 22, 2012

Progressive Confusion, Memory Loss, and Gait Ataxia in an Adult

A 62-year-old woman is seen in the emergency department for progressive confusion, memory loss, and gait instability over a 6-month period with noticeable worsening over the last 2 months.

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May 8, 2012

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May 8, 2012

Corneal Trauma in a 6-Year-Old Boy

A 6-year-old boy presents with worsening photophobia, irritation, and redness in his right eye for 5 days.

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April 24, 2012

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April 24, 2012

Episodic Abdominal and Chest Pain in a Young Adult

A 49-year-old man with a history of severe eczema presents to your office with slightly eroded, erythematous scaly patches on the his face, chest, and back.

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April 10, 2012

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April 10, 2012

Vesicular Eruption

A 49-year-old man with a history of severe eczema presents to your office with slightly eroded, erythematous scaly patches on the his face, chest, and back.

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March 27, 2012

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March 27, 2012

Blue Sclerae

A 60-year-old man with a history of multiple fractures after minor trauma presents for evaluation of anemia with a hemoglobin level of approximately 9 g/dL.

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March 13, 2012

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March 13, 2012

Rapidly Expanding Facial Eschar in a Severely Injured Trauma Patient

A 21-year-old woman presents to the trauma resuscitation unit via helicopter transport following a motor vehicle crash.

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February 21, 2012

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February 21, 2012

Patient With a Rash, Abdominal Pain, and Weight Loss

A 49-year-old man presents with right iliac fossa pain of 36 hours' duration. He reports loss of appetite, weight loss, and increasing lethargy over the preceding 10 months.

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February 7, 2012

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February 7, 2012

Rash in an Immunocompromised Patient

A 48-year-old man with low-risk acute promyelocytic leukemia (APL) undergoes induction chemotherapy with daily all-trans retinoic acid (tretinoin), cytarabine (days 1-7), and daunorubicin (days 1-3).

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January 24, 2012

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January 24, 2012

Papules, Plaques, and Nodules in an Immunocompromised Patient

An 85-year-old man is admitted for evaluation of multiple papules, plaques, and subcutaneous nodules on his face, trunk, and extremities.

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January 10, 2012

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January 10, 2012

Purple Urine

An elderly frail woman with dementia was admitted to the internal medicine service because of malfunction of her percutaneous gastrostomy tube.

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December 20, 2011

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December 20, 2011

Decreased Vision Following Eye Trauma

A 52-year-old man presented to the emergency department (ED) for evaluation after several days of increasingly blurred vision in the right eye.

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December 6, 2011

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December 6, 2011

Right Femoral Neck Fracture

A 23-year-old woman was referred for evaluation of a right femoral neck pathologic fracture.

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November 22, 2011

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November 22, 2011

Acute-Onset Reticulated White Lip

A 62-year-old woman returns to your office with a diffuse, pruritic rash on her lips, palms, and upper back 2 weeks after starting lisinopril.

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November 1, 2011

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November 1, 2011

Indurated, Purplish Plaque on a Newborn

A female neonate carried to term and born weighing 2.87 kg was delivered spontaneously to a 29-year-old woman with no medical illness.

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October 2011

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October 2011

Lower Abdominal Swelling and Scrotal Enlargement

A 24-year-old man reports progressive, right lower abdominal swelling and right scrotal enlargement over 2 years.

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September 2011

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September 2011

Periocular Rash

A healthy 5-year-old boy presented with a 3-month history of an erythematous rash around his left eye.

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August 2011

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August 2011

Skin Fragility and Blister Formation

A 3-year-old girl native of the tribe Ngöbe-Buglé (Panama) was referred for evaluation of a history of skin fragility and blister formation since adoption 2 years earlier.

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July 2011

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July 2011

Frontal Headache

A 47-year-old Brazilian woman presented to a walk-in clinic reporting a headache of 8 days' duration that started in the frontal area and evolved into a holocranial headache.

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June 2011

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June 2011

Superficial Corneal Growth

During a routine office visit, you notice that your patient, a 70-year-old white man, has a small superficial growth on the surface of his right eye that you do not remember seeing before.

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May 2011

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May 2011

Lower Extremity Purpura

A 50-year-old woman comes to your office for evaluation of a vasculitic-appearing cutaneous eruption of unknown duration on the lower extremities.

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