Four photos, 5 short real-life cases: can you solve these 5 diagnostic mysteries?
Question 1:
A 59-year-old woman with a history of peptic ulcer disease presented with a several day history of epigastric pain. Her past medical history included a Billroth II procedure with Roux-en-Y revision for an anastomotic bleed. Upper endoscopy showed a normal gastric remnant, an ulcer at the anastomotic site, and a large bezoar on the gastric side of anastomosis. Biopsy confirmed the diagnosis of phytobezoar.
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Question 2:
A 45-year-old man complained about moderate itching and scaling between his toes on both feet.
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Question 3:
A 44-year-old woman presented with progressive dysphagia and associated nausea and vomiting of 2 weeks’ duration.
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Question 4:
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Question 5:
A 47-year-old HIV-positive man presented with severe thrush, profound dysphagia, and a 30-lb weight loss. He underwent an upper endoscopy with biopsies. Specimens revealed unspeciated Candida.
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ANSWER KEY:
Question 1. G
Question 2. D
Question 3. B
Question 4. A
Question 5. A