You are correct. This pt was diagnosed w/ acute primary angle-closure glaucoma (APACG), a rare but sight-threatening condition caused by an acute rise in intraocular pressure secondary to blockage of aqueous outflow. Risk factors include increasing age, Asian and Inuit ethnicity, female sex, and hypermetropia. Attacks can be precipitated by mydriasis, such as that caused by anticholinergic drugs and low-light situations. After emergency medical management w/ IV acetazolamide and eye drops, this pt had a right, then left, peripheral iridotomy before having argon laser iridoplasty in the right eye. Always consider APACG in a pt, irrespective of age and sex, who presents w/ headache or eye pain, and loss of vision in a red eye w/ a mid-dilated pupil.

You are correct. Findings were diagnostic for central retinal vein occlusion (CRVO). All investigations, including thrombophilia screen, were normal. The pt had been on desogestrel (a progesterone-only pill) for 3 mo. She was advised to stop the pill and was started on low-dose aspirin. CRVO completely resolved w/in a mo. The incidence of thrombosis differs across progesterone-only contraceptives, w/ desogestrel having the highest risk.

You are correct. Analysis of skin swabs from the groin, nose, and one of the lesions confirmed a suspicion of Panton-Valentine leucocidin (PVL)-positive S aureus. PVL-positive S aureus is a virulent, highly transmissible community-acquired strain that may cause recurrent skin infxns. This pt responded to a further course of flucloxacillin + skin decontamination w/ mupirocin; her skin cleared, and seizure control returned to normal.

You are correct. Gorlin sign is seen in half of patients w/ Ehlers-Danlos syndrome and systemic hypermobility. There is a link between Ehlers-Danlos syndrome and TMJ dysfunction, and clinicians should attempt to elicit this sign when assessing pts w/ temporomandibular joint or rheumatological problems. Only 8% to 10% of the “normal” population can perform this maneuver.

You are correct. History revealed participation in a game that tests the ability to withstand discomfort associated w/ close proximity to discharge of an aerosol canister. The recreational practice of ‘frosting’ (‘having a frosty’) involves the discharging of pressurized aerosol contents onto body surfaces. Resultant frostbite depends on duration of exposure and absolute temp reached. Unlike heat thermal burns, such cold injuries do not induce protein (dermal collagen) fragmentation; thereby, there is reduced likelihood of scar formation. Tx consists of simple nonabsorbent dressings, daily review, and avoidance of UV exposure to reduce subsequent hyperpigmentation. All cases merit consideration for psychosocial evaluation.

You are correct. A diagnosis of kerion was made and confirmed when scrapings from the child’s eyebrow grew Trichophyton verrucosum. He was treated w/ oral terbinafine and antibiotics. Kerion is an inflammatory reaction to ringworm, usually seen on the scalp of children and occasionally on the beard area of adults; secondary bacterial infxn is common. Prompt tx minimizes risk of scarring and permanent hair loss.

You are correct. She was diagnosed w/ infantile hemangioma in its proliferative phase. Infantile hemangioma is the most common vascular tumor of infancy, affecting 5% of infants. The incidence is highest in female and premature infants. Unlike congenital vascular malformations, this benign lesion is typically not present at birth but appears in the first few wks of life as a small red macule. Hemangiomas then follow a 3-phase growth pattern of proliferation, involution, and resolution, during which they typically proliferate rapidly for a period of 3 to 6 mo, and then involute spontaneously, w/ 90% completely disappearing by 9 yrs of age.