You are correct. MRI showed carotid artery dissection, without abnormal signal in the hypoglossal nerve. Isolated hypoglossal nerve palsy is associated with lesions of the peripheral segment rather than at the brainstem origin. The hypoglossal nerve passes between the carotid artery and the internal jugular vein. In one series, >5% of patients with internal carotid artery dissection presented with isolated hypoglossal nerve involvement. This patient was treated with antihypertensive and antiplatelet medication. Symptoms improved by 3 weeks after admission.

You are correct. Reexpansion pulmonary edema is a complication of drainage of pleural effusions and pneumothoraces. Large volume, clear (not bloody) sputum is common. X-ray reveals unilateral diffuse airspace opacification of the reinflated lung with the chest tube in place. Management is supportive. The use of diuretics for the condition is controversial. This patient rapidly improved with high-flow O2, morphine, and furosemide; he was discharged 2 days later.

You are correct. Blistering distal dactylitis is a superficial bacterial infection of the anterior fat pad, typically caused by gram-positive organisms. It presents with large blisters or bullae affecting multiple fingers. His clinicians hypothesized that lacing up hockey skates may have caused superficial microtrauma to the hands, predisposing to potential infection. Moist, infrequently washed hockey equipment may have harbored infectious organisms. He improved after 10 days of oral cephalexin, blister debridement via lateral puncture, and silver sulfadiazine dressings.

You are correct. Nasal polyps, a benign inflammation of the nasal sinus mucosa, are a common cause of nasal obstruction and often result from chronic rhinosinusitis. Initial treatment is with topical steroids. This patient did not respond to steroids; nasal polypectomy was performed.

You are correct. The autoimmune disease myasthenia gravis often presents with bilateral complex external ophthalmoplegia. Symptoms are often worse in the evening and after exertion. Long tract signs, sensory symptoms, and headache are absent. Diagnosis is confirmed with IV edrophonium test. This patient improved with the usual treatment of anticholinesterase drugs and corticosteroids.

You are correct. She meets criteria for Behcet disease: recurrent oral ulcers with 2 of these 4: recurrent genital ulcerations, eye lesions (uveitis or retinal vasculitis), skin lesions (erythema nodosum or folliculitis), positive pathergy test (a small red bump or sterile pustule after an intracutaneous insult). Most common along the Old Silk Road from the Far East to the Mediterranean, the condition was named after Turkish dermatologist Hulusi Behcet. The patient improved on corticosteroids and colchicine.

You are correct. Capsule endoscopy revealed whipworms, Trichuris trichiura, a major nematode species affecting the human bowel, in the ileocecal valve. Ultrasound findings of thickened ileal wall and fluid-filled loops are not pathognomonic, but in the clinical context raise the suspicion of a malabsorption condition. The patient recovered rapidly with a course of mebendazole and short-term iron supplementation.

You are correct. The image shows molluscum-associated dermatitis caused by the molluscipoxvirus. The small, pearly, dome-shaped papules with central umbilication favor intertriginous areas, although they may appear anywhere. Molluscum contagiosum infection may result in an associated dermatitis thought to be secondary to a delayed hypersensitivity reaction to the virus. The specific onset of dermatitis confined to the site of the molluscum favors the diagnosis of molluscum-associated dermatitis over atopic dermatitis. The condition is usually self-limited.