OctoMed/NEJM-Image-Challenge · Datasets at Hugging Face

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1	apr-01-2010	This 4-year-old boy presented with a 5-day history of mild fever and malaise and a 3-day history of rash. What is the diagnosis?	yes	12%	62%	10%	11%	6%	96521	0.037	22a308b8983b3dcb60375bac04347a26	[ "A: Erythema infectiosum", "B: Hand, foot, and mouth disease", "C: Kawasaki disease", "D: Measles", "E: Pityriasis rosea" ]	B: Hand, foot, and mouth disease
2	apr-01-2021	A 5-year-old girl presented with a 4-week history of painful swelling on both sides of her lower abdomen. Six weeks before presentation, her parents removed a tick they found buried in her umbilicus. Five days after this she developed fevers. What is the diagnosis?	yes	17%	16%	31%	21%	16%	130077	0.12	710db3c4b917d478ee231f50416c16f5	[ "A: Ehrlichiosis", "B: Babesiosis", "C: Tularemia", "D: Lyme disease", "E: Rocky Mountain spotted fever" ]	C: Tularemia
3	apr-02-2009	What is the diagnosis?	no	6%	39%	31%	10%	14%	129386	0.1	0d08dbca65e634e1efcb54348c2e6f84	[ "A: Carcinoid syndrome", "B: Dermatomyositis", "C: Endocarditis", "D: Lichen planus", "E: Porphyria" ]	B: Dermatomyositis
4	apr-02-2015	What is the most likely diagnosis in this 65-year-old woman with a 7-day history of throat pain and difficulty swallowing?	yes	40%	27%	6%	20%	7%	113962	0.096	76643769fc511d50976faed3b2c882a9	[ "A: Epiglottitis", "B: Foreign body aspiration", "C: Peritonsillar abscess", "D: Retropharyngeal abscess", "E: Thyroid nodule" ]	A: Epiglottitis
5	apr-02-2020	A 2-year-old boy who was born at full term and had been delivered with the assistance of forceps presented to the otolaryngology clinic with an 18-month history of flushing on his right cheek that appeared when he ate. Flushing appeared when he ate strawberries in the clinic and was not associated with pain, pruritus, sweating, or respiratory symptoms. The findings from the remainder of the examination were normal. What is the underlying condition?	yes	61%	15%	10%	7%	7%	57038	0.039	758ff9dd0c5c51b25b8751a4c40d5abd	[ "A: Frey’s syndrome", "B: Food allergy", "C: Rosacea", "D: Autonomic epilepsy", "E: Carcinoid syndrome" ]	A: Frey’s syndrome
6	apr-03-2008	A patient with this tomogram would be most likely to present with which one of the following signs?	yes	23%	37%	12%	12%	15%	118628	0.1	a9fefa553b6b8c3a599e4763a12f8333	[ "A: Uniocular blindness", "B: Hemiplegia", "C: Alexia without agraphia", "D: Hemiballismus", "E: Internuclear ophthalmoplegia" ]	B: Hemiplegia
7	apr-03-2014	What is the diagnosis?	no	11%	8%	61%	6%	14%	77860	0.039	82081ef87459ddf47974f34e98609389	[ "A: Empyema", "B: Lymphangioleiomyomatosis", "C: Paraesophageal hernia", "D: Pericardial effusion", "E: Plombage" ]	C: Paraesophageal hernia
8	apr-04-2013	What is the diagnosis?	no	8%	23%	8%	48%	13%	75732	0.071	265de82ee3128df8baf91b1398bacb40	[ "A: Adrenal cancer", "B: Echinococcal infection", "C: Meckel's diverticulitis", "D: Pneumatosis intestinalis", "E: Trichobezoar" ]	D: Pneumatosis intestinalis
9	apr-04-2019	A 48-year-old man presented to the ophthalmology clinic with a 1-week history of pain, double vision, and blurred vision in his left eye. What is the abnormality depicted here?	yes	75%	9%	8%	1%	6%	64348	0.016	ee7bbc90717eb551fba5f8be9abdc66a	[ "A: Separation of the iris", "B: Separation of the pupil", "C: Separation of the lens", "D: Normal eye finding", "E: Separation of the sclerae" ]	A: Separation of the iris
10	apr-05-2007	This 9-kg liver was removed at the time of liver transplantation. What is the diagnosis?	yes	14%	7%	12%	63%	5%	114695	0.036	5240a28586c31856b7714ea8c42a4171	[ "A: Macronodular cirrhosis", "B: Hepatocellular carcinoma", "C: Echinococcosis", "D: Polycystic liver disease", "E: Trophoblastic tumor" ]	D: Polycystic liver disease
11	apr-05-2012	What is the diagnosis?	no	7%	58%	26%	4%	5%	95890	0.051	6a21a1d2ee88735c71dc42801b5bdab8	[ "A: Granulomatosis with polyangiitis (Wegener's)", "B: Lepromatous leprosy", "C: Neurofibromatosis type 1", "D: Sarcoidosis", "E: Tertiary syphilis" ]	B: Lepromatous leprosy
12	apr-05-2018	A 21-year-old woman presented to the emergency department with an 8-month history of swelling and pain in the right thigh. MRI of the right leg revealed a large periosteal femoral mass and thrombus in the right femoral vein, for which she received anticoagulation therapy. The patient subsequently experienced dyspnea and pleuritic chest pain, and a chest x-ray was done. What is the likely diagnosis?	yes	9%	14%	16%	43%	18%	186500	0.082	f57669f6e808686fe7d8a5836a535c3e	[ "A: Pulmonary embolism", "B: Pulmonary sarcoidosis", "C: Eosinophilic granulomatosis with polyangiitis", "D: Chondroblastic osteosarcoma", "E: Miliary tuberculosis" ]	D: Chondroblastic osteosarcoma
13	apr-06-2006	This 36-year-old man has undergone renal transplantation and parathyroidectomy. What is the most likely cause of the changes in his hands?	yes	44%	14%	37%	3%	2%	88222	0.094	54c6d230737ded9ff7dc98eafda961ec	[ "A: Pseudoclubbing", "B: Albright's hereditary osteodystrophy", "C: Hypertrophic osteoarthropathy", "D: Yellow nail syndrome", "E: Psoriasis" ]	A: Pseudoclubbing
14	apr-06-2017	A 3-year-old boy presented with a 6-month history of gross hematuria, and was found to have kidney, bladder, and ureteral stones. Which of the following factors predisposed this boy to genitourinary stone formation?	yes	10%	10%	63%	9%	8%	69416	0.034	1ca599712907e3340bf93e17f5c36ead	[ "A: Phenylketonuria", "B: Ornithine transcarbamylase deficiency", "C: Primary hyperoxaluria", "D: Acid maltase deficiency (Pompe disease)", "E: Pyruvate kinase deficiency" ]	C: Primary hyperoxaluria
15	apr-06-2023	An 87-year-old man with chronic kidney disease, hypertension, and atrial fibrillation presented to the emergency department with a 3-day history of constipation and lower abdominal pain. Physical examination was notable for abdominal distention and tenderness to palpation of the right lower quadrant without rebound or guarding. A plain radiograph of the abdomen is shown. What is the most likely diagnosis?	yes	57%	6%	5%	23%	10%	30921	0.051	54f083d5b14a455dfbb4744b94ea466b	[ "A: Cecal volvulus", "B: Constipation", "C: Hiatal hernia", "D: Ogilvie’s Syndrome (acute colonic pseudo-obstruction)", "E: Small bowel obstruction" ]	A: Cecal volvulus
16	apr-07-2011	What is the diagnosis?	no	16%	7%	8%	11%	58%	99378	0.045	4c746a45fa8ec7bb530dd9367c63a806	[ "A: Dermatitis herpetiformis", "B: Impetigo", "C: Measles", "D: Secondary syphilis", "E: Varicella" ]	E: Varicella
17	apr-07-2016	What is the most likely diagnosis in a patient with dysarthria and gait instability and this finding?	yes	14%	18%	10%	12%	45%	93055	0.076	57e364ea780e466be3ba61d7bc63afbf	[ "A: Huntington's disease", "B: Wilson's disease", "C: Middle cerebral artery stroke", "D: NMDA receptor encephalitis", "E: Metronidazole-associated encephalopathy" ]	E: Metronidazole-associated encephalopathy
18	apr-07-2022	A 30-year-old man with Crohn's disease presented to the dermatology clinic with multiple painful ulcers in his groin and perineal area, as well as an ongoing Crohn's disease flare with fatigue, abdominal pain, and bloody diarrhea. Physical examination of the skin showed deep, linear erosions across the perineum and inguinal folds, on the scrotum and penile shaft, and in the intergluteal cleft. Which of the following is the most likely etiology underlying the genital ulcers?	yes	15%	64%	6%	6%	8%	31111	0.033	0da80e1e80aba8308f4aee22f58152f7	[ "A: Ecthyma gangrenosum", "B: Knife-cut ulcers from Crohn’s disease", "C: Lichen sclerosus", "D: Linear IgA disease", "E: Pemphigus foliaceus" ]	B: Knife-cut ulcers from Crohn’s disease
19	apr-08-2010	This patient was trying to look right when the image was taken. What is the diagnosis?	yes	9%	10%	21%	13%	47%	103941	0.072	3cbdda08793d8e9ee94fcc609a43319b	[ "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" ]	E: Right sixth cranial nerve palsy
20	apr-08-2021	A 68-year-old woman presented to clinic with a 40-year history of worsening hyperkeratotic non-painful, non-pruritic papules and plaques on her hands and feet. Her mother, son, and granddaughter had similar lesions. What is the diagnosis?	yes	4%	72%	5%	11%	7%	71861	0.02	b298e5a9c5c45b56c98c53003ea7cd6d	[ "A: Erythema multiforme", "B: Punctate palmoplantar keratoderma", "C: Incontinentia pigmenti", "D: Tuberous sclerosis", "E: Syphilis" ]	B: Punctate palmoplantar keratoderma
21	apr-09-2009	What term is used to describe this finding?	no	9%	8%	9%	62%	12%	113468	0.036	256b9edd63cdd052280124700bfa2dd4	[ "A: Arc eye", "B: Asthenopia", "C: Choroideremia", "D: Coloboma", "E: Corectopia" ]	D: Coloboma
22	apr-09-2015	What is the most likely cause of this physical exam finding in a 65-year-old woman undergoing treatment for breast cancer?	yes	9%	48%	24%	11%	8%	90516	0.071	d6d7552e25e6dde7b89e578c6e9301c2	[ "A: Vitamin E deficiency", "B: Chemotherapy", "C: Scleroderma", "D: Chronic inflammatory demyelinating polyneuropathy", "E: Mercury toxicity" ]	B: Chemotherapy
23	apr-09-2020	A 45-year-old woman was referred to the outpatient clinic after multiple hepatic lesions were incidentally noted on imaging. She had no related symptoms. The physical examination and laboratory tests were all normal. Enhanced computed tomography of the abdomen had shown multiple small, hypodense, nonenhancing nodules throughout the liver. Magnetic resonance imaging with cholangiopancreatography revealed multiple small, T2-weighted, hyperintense cystic nodules in the liver, without biliary duct communication, creating a "starry sky" appearance. What is the diagnosis?	yes	4%	48%	15%	10%	23%	64551	0.071	9749b77fb59101c21714b7476446d40d	[ "A: Acute hepatitis", "B: Multiple biliary hamartomas", "C: Malignant hydatidosis", "D: Multiple liver metastases", "E: Caroli syndrome" ]	B: Multiple biliary hamartomas
24	apr-10-2008	This rash appeared following treatment for leukemia. What is the diagnosis?	yes	18%	17%	4%	41%	21%	127715	0.091	7c48805e409ecfaf6137fc38e9b103cc	[ "A: Cryoglobulinemia", "B: Leukemia cutis", "C: Herpes zoster", "D: Graft-versus-host disease", "E: Urticaria pigmentosa" ]	D: Graft-versus-host disease
25	apr-10-2014	What is the diagnosis?	no	30%	20%	8%	30%	11%	116652	0.168	16c5f7db46777c341e3fd102bcc5c09f	[ "A: Blastomycosis", "B: Celiac disease", "C: Down's syndrome", "D: Hyperparathyroidism", "E: IgA nephropathy" ]	B: Celiac disease
26	apr-11-2013	What is the diagnosis?	no	49%	13%	8%	26%	4%	75898	0.071	fd164aacec343bdd070cebdfdc793fa0	[ "A: Amelanotic melanoma", "B: Angioma", "C: Dermal nevus", "D: Pyogenic granuloma", "E: Wart" ]	A: Amelanotic melanoma
27	apr-11-2019	A 35-year-old man presented to the emergency department with a 2-day history of abdominal pain, headache, and brown urine. He was alert and oriented to time, place, and self. He had no purpura or petechiae. Laboratory evaluation revealed a hemoglobin level of 8.6 g per deciliter (normal range, 13.7 to 17.5) and a platelet count of 6000 per cubic millimeter (normal range, 140,000 to 370,000). Levels of indirect bilirubin and lactate dehydrogenase were elevated, haptoglobin was undetectable, and the serum creatinine level was 1 mg per deciliter (88 umol per liter; normal range, 0.6 to 1.3 mg per deciliter [57 to 115 umol per liter]). Test results for infection with the human immunodeficiency virus were negative. A peripheral-blood smear showed numerous schistocytes. What is the diagnosis?	yes	13%	43%	8%	24%	12%	86397	0.084	825aefb4c6e86911a1a9ff4f6dc90798	[ "A: Idiopathic thrombocytopenic purpura", "B: Thrombotic thrombocytopenic purpura", "C: Pseudotrombocytopenia", "D: Hemolytic-uremic syndrome", "E: Excessive splenic platelet sequestration" ]	B: Thrombotic thrombocytopenic purpura
28	apr-12-2007	What is the diagnosis?	no	6%	36%	8%	12%	38%	115281	0.108	f3ba23e4129701bd68c7127ef14937d0	[ "A: Intracranial hemorrhage", "B: Osteoma", "C: Neurocysticercosis", "D: Arachnoid cyst", "E: Meningioma" ]	E: Meningioma
29	apr-12-2012	What is the diagnosis?	no	6%	13%	11%	17%	53%	87068	0.056	5b26f982458eed01a6ae19dc169b6018	[ "A: Cryptorchidism", "B: Femoral-artery pseudoaneurysm", "C: Iliopectineal bursitis", "D: Inguinal hernia", "E: Metastatic inguinal lymphadenopathy" ]	E: Metastatic inguinal lymphadenopathy
30	apr-12-2018	A 70-year-old man presented to the ophthalmology clinic with a 1-year history of progressive bluish discoloration of the sclerae of both eyes. He reported no ocular discomfort or blurry vision. He had previously received a diagnosis of an inflammatory arthritis for which he had been taking minocycline for more than 15 years. Examination was notable for bluish discoloration of the sclera of both eyes and pinnae of both ears. Ophthalmologic examination was otherwise normal. What is the diagnosis?	yes	13%	65%	8%	8%	6%	68753	0.031	e2aa978d299aeeab7c99907e8fccf89f	[ "A: Osteogenesis imperfecta", "B: Minocycline-induced pigmentation", "C: Ehlers-Danlos syndrome", "D: Primary acquired melanosis", "E: Conjunctival melanoma" ]	B: Minocycline-induced pigmentation
31	apr-13-2006	This 46-year-old woman developed pruritus and similar papular lesions over her axillae, groin, and buttocks. What is the most likely diagnosis?	yes	3%	4%	5%	8%	80%	66795	0.01	fab61e3d1fc500942aa0dc8eb57befd7	[ "A: Pilonidal sinus", "B: Psoriasis", "C: Impetigo", "D: Dermatomyositis", "E: Scabies" ]	E: Scabies
32	apr-13-2017	A 6-year-old girl presented with short stature, impaired hearing, and vision loss at 2 years of age. A radiograph of her wrists show the following features. What is the diagnosis?	yes	13%	46%	18%	14%	9%	96827	0.074	8468a24b04b771116b00ca8854f7af17	[ "A: Lead poisoning", "B: Osteopetrosis", "C: Fibrous dysplasia", "D: Hypoparathyroidism", "E: Hypervitaminosis D" ]	B: Osteopetrosis
33	apr-13-2023	A 34-year-old woman with tobacco use disorder was referred to the pulmonary clinic for worsening dyspnea and dry cough. She had chronic hypoxemic respiratory failure of unknown cause, requiring supplemental oxygen. Computed tomography of the chest showed diffuse ground-glass opacities and areas of peripheral consolidation but no basilar reticulations or honeycombing. Bronchoalveolar lavage was not diagnostic, so surgical lung biopsy was performed. Histopathological analysis showed extensive alveolar filling with pigment-laden macrophages. What is the most likely diagnosis?	yes	39%	12%	10%	15%	23%	38273	0.094	d48f7b5997ceccd9ba035c99e13d6f91	[ "A: Desquamative interstitial pneumonia", "B: Diffuse alveolar hemorrhage", "C: Idiopathic pulmonary fibrosis", "D: Lipoid pneumonia", "E: Pulmonary alveolar proteinosis" ]	A: Desquamative interstitial pneumonia
34	apr-14-2011	What is the most likely diagnosis?	no	17%	6%	9%	29%	39%	127332	0.099	b7f21b63216b4cf6bedd1d950acdc183	[ "A: Calciphylaxis", "B: Factor V Leiden", "C: Protein C deficiency", "D: Scleroderma", "E: Waldenstrom's macroglobulinemia" ]	E: Waldenstrom's macroglobulinemia
35	apr-14-2016	What is the most likely cause of this physical finding?	no	8%	59%	12%	11%	9%	107013	0.042	a93c1db4f0e8d736eb04d0f2c6d941a1	[ "A: Ascariasis", "B: Esophagogastric bypass", "C: Hirschsprung's disease", "D: Acute intestinal pseudo-obstruction", "E: Cutaneous leishmaniasis" ]	B: Esophagogastric bypass
36	apr-14-2022	A 64-year-old man with metastatic lung adenocarcinoma who had recently started high-dose steroids for malignant spinal cord compression developed an itchy rash and diarrhea. He had a 3-year history of intermittent peripheral eosinophilia of unknown cause. What is the most likely diagnosis?	yes	21%	14%	40%	16%	10%	81969	0.092	ec548f83dbd871577fc45ad94b286ce3	[ "A: Cutaneous larva migrans", "B: Cutaneous schistosomiasis", "C: Larva currens from Strongyloides", "D: Lichen striatus", "E: Scabies" ]	C: Larva currens from Strongyloides
37	apr-15-2010	What is the diagnosis?	no	46%	26%	14%	8%	6%	88766	0.078	e4782a5eca3fe76a3d4caaab223c76fc	[ "A: Duodenal perforation", "B: Emphysematous pyelonephritis", "C: Perinephric cyst", "D: Situs inversus", "E: Ureterocele" ]	A: Duodenal perforation
38	apr-15-2021	A 27-year-old primigravid woman was admitted with new-onset diabetes and hypertension at 32 weeks of gestation. She had worsening proximal muscle weakness, striae, and facial plethora for several months. Physical examination showed striae over the abdomen, breasts, and dorsal and supraclavicular fat pads. Laboratory studies were notable for a potassium of 2.9 mmol per liter (reference range, 3.5 to 5.5) and a urine protein:creatinine ratio of 24 (reference value, <30). What is the most likely diagnosis?	yes	13%	9%	24%	50%	5%	104566	0.067	0189828491c96333a75abc9ecf1ced51	[ "A: Eclampsia", "B: Hyperthyroidism", "C: Addison’s disease", "D: Adrenal mass", "E: Parathyroid mass" ]	D: Adrenal mass
39	apr-16-2009	What is the diagnosis?	no	11%	53%	7%	19%	10%	116464	0.057	b2afd7dcdf273204c5a638dcf8a668a5	[ "A: Epidermolysis bullosa", "B: Hereditary hemorrhagic telangiectasia", "C: Neurofibromatosis", "D: Peutz-Jeghers syndrome", "E: Scleroderma" ]	B: Hereditary hemorrhagic telangiectasia
40	apr-16-2015	What is the most likely diagnosis in this 50-year-old woman with atrial fibrillation who sees halos around lights?	yes	5%	19%	14%	6%	56%	84438	0.051	68d4d486fc43cf86a2a1d13e4953f709	[ "A: Early cataract", "B: Herpes simplex virus keratitis", "C: Digoxin-associated visual disturbance", "D: Amaurosis fugax", "E: Amiodarone-induced vortex keratopathy" ]	E: Amiodarone-induced vortex keratopathy
41	apr-16-2020	A 71-year-old man was hospitalized with altered mental status progressing over the preceding 3 weeks. The patient had a recent diagnosis of adenocarcinoma of the colon with known metastatic lesions in the lung and bones. A gadolinium-enhanced magnetic resonance image of the brain was performed and is shown. What is the most likely diagnosis?	yes	12%	24%	47%	9%	7%	96161	0.073	93f05a8fde182f73c47aaeff6fa08234	[ "A: Group D streptococcus abscesses", "B: Neurocysticercosis", "C: Metastatic adenocarcinoma", "D: Tuberculosis", "E: Primary central nervous system lymphoma" ]	C: Metastatic adenocarcinoma
42	apr-17-2008	What is the diagnosis?	no	36%	3%	10%	39%	12%	128105	0.117	e4f8c2d40e7c1a7b28257eacfcc06aa7	[ "A: Babesiosis", "B: Iron deficiency anemia", "C: Hereditary spherocytosis", "D: Malaria", "E: Sideroblastic anemia" ]	A: Babesiosis
43	apr-17-2014	What is the diagnosis?	no	6%	6%	24%	13%	52%	75184	0.062	dc6ccc761d00369cf1bf69d8ac1e542f	[ "A: Blepharitis", "B: Entropion", "C: Eyelid wart", "D: Keratoconjunctivitis sicca", "E: Vernal keratoconjunctivitis" ]	E: Vernal keratoconjunctivitis
44	apr-18-2013	What diagnosis explains these lesions that developed after acupuncture to the area?	yes	20%	27%	25%	7%	20%	106232	0.144	4547d8c5c2e94ff85d8c80e5df15e423	[ "A: Herpetic whitlow", "B: Nummular eczema", "C: Psoriasis", "D: Ringworm", "E: Scabies" ]	C: Psoriasis
45	apr-18-2019	A 60-year-old woman presented to the ophthalmology clinic after noticing central blind spots in the visual fields of both eyes. She had a history of rheumatoid arthritis, which had been treated with hydroxychloroquine for 14 years. The retinal examination showed the pattern below. What is the most likely underlying cause of this abnormality?	yes	5%	68%	13%	5%	8%	42782	0.026	ce60c65aa040c398cdcff55a4d15564f	[ "A: Rheumatoid arthritis", "B: Hydroxychloroquine toxicity", "C: Age-related macular degeneration", "D: Type 2 diabetes", "E: Bardet-Biedl syndrome" ]	B: Hydroxychloroquine toxicity
46	apr-19-2007	What is the diagnosis?	no	9%	13%	5%	56%	17%	111961	0.05	16a7e101f49142f45a3afd960c51caff	[ "A: Syphilis", "B: Phenytoin exposure", "C: Marfan syndrome", "D: Torus palatinus", "E: Kaposi sarcoma" ]	D: Torus palatinus
47	apr-19-2012	Which of these medications, used to treat this patient's glioblastoma multiforme, is most likely to have contributed to this complication?	yes	11%	43%	10%	17%	18%	96463	0.082	16eaac00ee2aaa67a75f31858e95c9bc	[ "A: Acetazolamide", "B: Dexamethasone", "C: Levetiracetam", "D: Temozolomide", "E: Topotecan" ]	B: Dexamethasone
48	apr-19-2018	A 74-year-old woman presented to the emergency department with a 3-day history of lower abdominal pain, nausea, and vomiting. A plain-film radiograph of the abdomen showed marked dilatation of bowel loops and abrupt termination of gas within the descending colon, referred to as a colon cutoff sign.	yes	13%	35%	14%	14%	24%	128944	0.107	028d27a9c5ac00a54b366263382f9bc0	[ "A: Diaphragmatic hernia", "B: Acute pancreatitis", "C: Toxic shock syndrome", "D: Lead poisoning", "E: Crohn’s disease" ]	B: Acute pancreatitis
49	apr-20-2006	This 63-year-old man with a 10-year history of progressive neck enlargement noted a sudden increase in the size of the swelling on the left side. What is the most likely diagnosis?	yes	16%	8%	37%	17%	22%	92009	0.101	d830b4550dad00fbdba162d661c8c2dd	[ "A: Superior vena cava syndrome", "B: Scrofula", "C: Bleeding into a thyroid nodule", "D: Non-hodgkins lymphoma", "E: Follicular thyroid carcinoma" ]	C: Bleeding into a thyroid nodule
50	apr-20-2017	A 30-year-old man presented with this lesion on his right lower eyelid that had grown over 3 days. Two weeks before his presentation, a cyst had ruptured on the same eyelid. What is the diagnosis?	yes	17%	4%	5%	62%	12%	84701	0.038	525b57975503d190a322a94367a3b5f3	[ "A: Squamous papilloma", "B: Amelanotic melanoma", "C: Squamous-cell carcinoma", "D: Pyogenic granuloma", "E: Suture granuloma" ]	D: Pyogenic granuloma
51	apr-20-2023	A 60-year-old left-handed woman presented to the emergency department with pain in her left forearm. The arm was swollen and tender, especially with passive pronation and supination. The overlying skin was intact, and the results of neurovascular examination were normal. Radiographs of the left forearm were performed (upper image, anteroposterior view; lower image, lateral view). The findings should raise concern for which contributory factor?	yes	42%	15%	12%	19%	12%	41942	0.085	d6ca50da3aede1ecf8fd6047370ff76f	[ "A: Assault", "B: Fall", "C: Malignancy", "D: Osteoporosis", "E: Repetitive strain" ]	A: Assault
52	apr-21-2011	What is the diagnosis?	no	24%	29%	11%	16%	20%	153754	0.164	998146f48ca9e7e68b23749f4231b76b	[ "A: Erythema marginatum", "B: Erythema multiforme", "C: Pityriasis rosea", "D: Tinea versicolor", "E: Tuberculoid leprosy" ]	E: Tuberculoid leprosy
53	apr-21-2016	What is the most likely diagnosis in an elderly woman with dyspnea and these findings?	yes	9%	64%	8%	8%	10%	69714	0.032	ae6d814adb970970bd69e848e76e59ef	[ "A: Esophageal tumor", "B: Vein-graft aneurysms", "C: Thymoma", "D: Liposarcoma", "E: Hemangioma" ]	B: Vein-graft aneurysms
54	apr-21-2022	A 56-year-old man with sickle hemoglobin C disease and proliferative sickle cell retinopathy presented for a routine eye examination. He was asymptomatic. What is seen on this examination of the anterior segment of the eye?	yes	24%	15%	33%	16%	12%	53751	0.114	2f46989159d4af54c5a73fc6a5550fbf	[ "A: Bilateral acute depigmentation of the iris (BADI)", "B: Cornea verticillata", "C: Iris atrophy", "D: Mutton-fat keratic precipitates", "E: Sunflower cataract" ]	C: Iris atrophy
55	apr-22-2010	What is the most likely diagnosis?	no	16%	7%	56%	11%	10%	103467	0.049	bdb4e140be3fb7dd37f1f8f1c6e5d6b1	[ "A: End-stage renal disease", "B: Graves' disease", "C: Iron deficiency", "D: Pseudohypoparathyroidism", "E: Sarcoidosis" ]	C: Iron deficiency
56	apr-22-2021	A 48-year-old man presented with a 2-week history of fever, shortness of breath, and painful skin lesions with blistering. His temperature was 39.2°C. What is the diagnosis?	yes	20%	23%	18%	26%	13%	180013	0.138	45424b397ee407c218c4b2396e917fcc	[ "A: Weil’s disease", "B: Staphylococcal scalded skin syndrome", "C: Legionnaires' disease", "D: Leprosy", "E: Lyme disease" ]	D: Leprosy
57	apr-23-2009	What is the diagnosis?	no	24%	8%	33%	15%	20%	205366	0.151	fdccd3d3100a46d2bca139711e1d269b	[ "A: Hypercholesterolemia", "B: Leukemia", "C: Lichen planus", "D: Pompe's disease", "E: Psoriasis" ]	A: Hypercholesterolemia
58	apr-23-2015	The following physical exam finding is most commonly associated with which one of the following?	no	49%	18%	16%	12%	6%	97279	0.067	d090fe75d278f5015c71bc3652d68aef	[ "A: Chronic kidney disease", "B: Thyroid dysfunction", "C: End-stage liver disease", "D: Pulmonary disease", "E: Systemic infection" ]	A: Chronic kidney disease
59	apr-23-2020	An 83-year-old woman presented to the gastroenterology clinic with dysphagia and regurgitation that occurred with every meal associated with postprandial chest pain. For several years she had difficulty swallowing both solids and liquids. Barium esophagram is shown. What is the diagnosis?	yes	17%	17%	13%	9%	43%	100982	0.082	3f67e08c03b8af5579802bcd92cc14b4	[ "A: Scleroderma", "B: Esophageal stricture", "C: Esophageal web", "D: Esophageal carcinoma", "E: Achalasia" ]	E: Achalasia
60	apr-24-2008	What is the diagnosis?	no	9%	26%	16%	7%	42%	105778	0.089	a814ba86cc8362c62a5fdb6df1507310	[ "A: Central retinal artery occlusion", "B: Diabetic papillopathy", "C: Ocular toxoplasmosis", "D: Optic neuritis", "E: Malignant hypertension" ]	E: Malignant hypertension
61	apr-24-2014	What is the cause of this new skin lesion in this patient whose blood CD4+ cell count was 20 per cubic millimeter (1%) following treatment for chronic lymphocytic leukemia?	yes	17%	6%	31%	23%	22%	201064	0.122	ba04fd43f42eefe641a9d1a70ef0fea6	[ "A: Bacillary angiomatosis", "B: Bullous impetigo", "C: Cryptococcosis", "D: Kaposi's sarcoma", "E: Verruca vulgaris" ]	C: Cryptococcosis
62	apr-25-2013	In addition to neurofibromatosis, what other examination finding would you expect for this patient?	yes	13%	12%	56%	9%	10%	71010	0.049	96b1bd987cc53d56b3d1fc50735b65a8	[ "A: Aortic regurgitation", "B: Chvostek sign", "C: Lisch nodules", "D: Thyroid bruit", "E: Web neck" ]	C: Lisch nodules
63	apr-25-2019	A 37-year-old man presented with a 4-year history of excessive sweating, headaches, and joint pain. His wife had also noticed increasing skin folds on his scalp. What is the most likely diagnosis?	yes	38%	19%	17%	11%	16%	171218	0.097	397f0a7a40a0bcbc2d3c052b266a4cbc	[ "A: Acromegaly", "B: Amyloidosis", "C: Systemic sclerosis", "D: Hypogonadism", "E: Sarcoidosis" ]	A: Acromegaly
64	apr-26-2007	In what vessel is this patient's dialysis catheter?	yes	11%	32%	33%	18%	6%	107164	0.12	eb240cc05f3d774a184cc77bddfc3297	[ "A: Left axillary vein", "B: Left internal mammary vein", "C: Left-sided superior vena cava", "D: Azygous vein", "E: Highest intercostal vein" ]	C: Left-sided superior vena cava
65	apr-26-2012	What is the most likely infecting organism in this patient with prostatitis?	yes	28%	12%	12%	15%	33%	93945	0.136	db1159ded67405646b4ec8ea1ed8e5f7	[ "A: Blastomyces dermatitidis", "B: Escherichia coli", "C: Histoplasma capsulatum", "D: Pseudomonas aeruginosa", "E: Staphylococcus aureus" ]	A: Blastomyces dermatitidis
66	apr-26-2018	A 31-year-old man presented to the emergency department with a 2-week history of left ear swelling. He had similar episodes over the past 2 years, and a 6-month history of weight loss, fatigue, and generalized aches. Physical exam revealed a swollen and tender ear, costochondral joints, and left knee. Lab tests showed an elevated erythrocyte sedimentation rate. What is the likely diagnosis?	yes	13%	8%	13%	13%	53%	111748	0.056	4c7587859b88d97a6161fe82436876e9	[ "A: Infectious perichondritis", "B: Rheumatoid arthritis", "C: Granulomatosis with polyangiitis", "D: Polyarteritis nodosa", "E: Relapsing polychondritis" ]	E: Relapsing polychondritis
67	apr-27-2006	A 39-year-old Zambian man who has tested positive for the human immunodeficiency virus presented with a three-week history of a draining neck mass. What is the most likely diagnosis?	yes	16%	41%	21%	12%	10%	85230.	0.088	c95060794df4aaea2f4877fb9164bd0a	[ "A: Actinomycosis", "B: Scrofula", "C: Kaposi sarcoma", "D: Burkitt lymphoma", "E: Nocardiosis" ]	B: Scrofula
68	apr-27-2017	A 25-year-old man presented to the emergency department with severe neck pain after a high-speed motor vehicle collision resulted in neck hyperextension. Axial CT scan of the C2 vertebrae is shown here. What is the diagnosis?	yes	48%	8%	12%	6%	25%	79770	0.071	03742f094dc0d7087d0045a6dab0fcf0	[ "A: Traumatic spondylolisthesis of the axis (hangman’s fracture)", "B: Odontoid fracture (dens fracture)", "C: Cervical spinous process fracture (Clay-shoveler fracture)", "D: Flexion tear drop fracture", "E: Cervical burst fracture (Jefferson fracture)" ]	A: Traumatic spondylolisthesis of the axis (hangman’s fracture)
69	apr-27-2023	A 75-year-old woman presented to the infectious diseases clinic with a 10-day history of painful lesions on the right hand and forearm. An aspiration of the hand lesion was performed. Bacterial culture of the aspirate grew filamentous, gram-positive, acid-fast branching rods. Which of the following activities likely preceded development of the lesions?	yes	21%	45%	10%	13%	11%	62473	0.077	e0250197ce2ec979f8e3237f2d11b526	[ "A: Cleaning a fish tank", "B: Gardening", "C: Getting bitten by a sandfly", "D: Handling feline waste", "E: Petting an armadillo" ]	B: Gardening
70	apr-28-2011	What is the diagnosis?	no	2%	7%	11%	73%	7%	92860	0.019	0579fd32596b4bfadefcc199a4b810bb	[ "A: Addison's disease", "B: Alkaptonuria", "C: Hematoma", "D: Melanoma", "E: Zidovudine exposure" ]	D: Melanoma
71	apr-28-2016	What is the most likely diagnosis in this man with left knee swelling and these findings for the past 2 years?	yes	14%	7%	14%	15%	51%	89991	0.061	98979040596bbb4669210d6bc01ad3c8	[ "A: Nonpulmonary tuberculosis", "B: Tularemia", "C: Cutaneous anthrax", "D: Sporotrichosis", "E: Actinomycosis" ]	E: Actinomycosis
72	apr-28-2022	A 53-year-old landscaper presented to the dermatology clinic with a 4-month history of red, raised, itchy skin lesions on his left lower back and buttock. Physical examination showed numerous verrucous nodules and plaques with overlying crusting and surrounding erythema on the left lower back and buttock. Grocott-Gomori methenamine silver staining showed broad-based budding organisms. Chest imaging showed no abnormalities. Which of the following is the best treatment?	yes	10%	57%	6%	15%	12%	48300	0.047	73b6c0908dac03ec8d3be2a6a420eef0	[ "A: Clarithromycin and amikacin", "B: Itraconazole", "C: Penicillin", "D: Rifampicin, isoniazid, pyrazinamide, and ethambutol", "E: Trimethoprim-sulfamethoxazole" ]	B: Itraconazole
73	apr-29-2010	What is the diagnosis?	no	5%	42%	5%	9%	39%	98161	0.1	0910c518725f9c555bcca2bddfe6f347	[ "A: Cerebral aneurysm", "B: Chiari I malformation", "C: Neurofibromatosis", "D: Paget disease", "E: Subdural hematoma" ]	B: Chiari I malformation
74	apr-29-2021	A 54-year-old man presented to the emergency department with confusion and vomiting. He also reported an unintentional 10 kg weight loss and progressive darkening of his skin over the past 6 months. Laboratory studies showed a serum glucose of 40 mg per deciliter (reference range, 70 to 110 mg per deciliter), sodium of 108 mmol per liter (reference range, 136 to 145), and a potassium of 6.4 mmol per liter (reference range, 3.5 to 5.1). What is the diagnosis?	yes	85%	4%	6%	3%	2%	34900	0.006	1f97d4f64141f6dc84f04f8ebd612687	[ "A: Primary adrenal insufficiency (Addison’s disease)", "B: Acanthosis nigricans", "C: Cushing’s disease", "D: Smoker’s melanosis", "E: Solar lentigines" ]	A: Primary adrenal insufficiency (Addison’s disease)
75	apr-30-2009	What is the diagnosis?	no	7%	8%	61%	10%	14%	103331	0.039	dce920232c50772aff2df98d1750a5ef	[ "A: Coxsackievirus infection", "B: Gorlin's syndrome", "C: Herpes zoster", "D: Orbital cellulitis", "E: Superficial pyoderma" ]	C: Herpes zoster
76	apr-30-2015	What is the most likely diagnosis?	no	7%	10%	14%	60%	10%	112843	0.041	fd9ada662d2af3067a360cbd6a5fc90e	[ "A: Staphyloma", "B: Pigmentary glaucoma", "C: Conjunctival hemorrhage", "D: Melanoma", "E: Squamous-cell carcinoma" ]	D: Melanoma
77	apr-30-2020	A 34-year-old man with a history of intravenous drug use and hepatitis C infection presented to the ophthalmology clinic with a 1-week history of pain and decreased vision in his right eye. The visual acuity was 20/400 in the right eye and 20/20 in the left eye. Slit-lamp examination of the right eye showed conjunctival injection and inflammation in the anterior chamber. Indirect ophthalmoscopy showed vitreous haze with yellow-white lesions on the retina and optic nerve. Following workup, surgery was performed and a white mass measuring 4 mm by 3 mm by 1 mm was seen adherent to the optic nerve. What is the most likely diagnosis/etiology?	yes	9%	10%	9%	61%	10%	40913	0.038	6ca6681c2cea5af4a548e47c267d8779	[ "A: Retinoblastoma", "B: Amelanotic uveal melanoma", "C: Astrocytic hamartoma", "D: Fungal endophthalmitis", "E: Malignant optic nerve prolapse" ]	D: Fungal endophthalmitis
78	aug-01-2013	What is the most likely diagnosis?	no	21%	19%	7%	30%	24%	109644	0.151	9ba88908b3390da7aeecfb9b6215c84c	[ "A: Discoid lupus", "B: Erythema migrans", "C: Psoriasis", "D: Tinea corporis", "E: Urticaria" ]	E: Urticaria
79	aug-01-2019	A 56-year-old woman presented to the emergency department with a 1-month history of abdominal pain in the left upper quadrant. Her medical history was notable for polysubstance use disorder, hepatitis C virus infection, and rheumatoid arthritis managed with naproxen. Computed tomography of the abdomen was performed. What is the most likely diagnosis?	yes	18%	9%	28%	35%	10%	85024	0.11	b1cab883e9444eb6b9a2cc61c9f8d00e	[ "A: Avascular necrosis of the spleen", "B: Visceral leishmaniasis", "C: Emphysematous infection of the spleen", "D: Gastrospenic fistulization", "E: Bezoar" ]	D: Gastrospenic fistulization
80	aug-02-2012	What is the diagnosis?	no	10%	19%	30%	25%	15%	165,436	0.144	b1781d720be0a3a00a0e0c7b3119cb70	[ "A: Congenital hypothyroidism", "B: Congenital syphilis", "C: Dentinogenesis imperfecta", "D: Neonatal hyperbilirubinemia", "E: Williams syndrome" ]	D: Neonatal hyperbilirubinemia
81	aug-02-2018	A 69-year-old man presented to the dermatology clinic with a 2-month history of a pruritic rash. The rash first appeared on his right wrist and within 2 weeks had spread to his arms, legs, and trunk. He had completed treatment for chronic hepatitis C virus (HCV) infection with a 12-week course of elbasvir and grazoprevir 3 months before the onset of the purple papular rash. Some lesions showed a fine reticulate pattern of dots and lines (Wickham's striae). What is the diagnosis?	yes	13%	16%	13%	47%	11%	96606	0.07	d5027dc84290c168a704d3583a5f4721	[ "A: Drug eruption", "B: Reactivation of endogenous latent varicella-zoster virus", "C: Discoid lupus erythematosus", "D: Lichen planus", "E: Pemphigus" ]	D: Lichen planus
82	aug-03-2006	What is the diagnosis?	no	30%	19%	31%	16%	4%	128251	0.126	5d6e74aaeca36cdc05903f3e2b8822fb	[ "A: Elephantiasis", "B: Hydrocele", "C: Inguinal hernia", "D: Non-seminomatous germ-cell tumor", "E: Testicular torsion" ]	C: Inguinal hernia
83	aug-03-2017	What is the most likely diagnosis for these two painless periumbilical masses in a 76-year-old man with type 2 diabetes mellitus?	yes	2%	9%	3%	80%	6%	67978	0.011	06d64a1ff70ad51f47ae5e6187c7f89e	[ "A: Abscess", "B: Dermatofibrosarcoma protuberans", "C: Hematoma", "D: Insulin-induced lipohypertrophy", "E: Nodular fasciitis" ]	D: Insulin-induced lipohypertrophy
84	aug-03-2023	A 95-year-old woman presented with a 4-week history of dyspnea and dry cough. She had not previously reported these symptoms to her doctor. For the past 6 months, she had been taking nitrofurantoin daily to prevent recurrent urinary tract infections. Her oxygen saturation was 83% on room air. Physical examination showed inspiratory crackles in the upper lung fields but no jugular venous distention or edema. Laboratory studies showed neutrophilic leukocytosis but no eosinophilia or elevations in aminotransferase levels. A sputum culture and viral respiratory panel were negative. Chest radiograph and computed tomography of the chest are shown. What is the most important element of the management of this condition?	yes	7%	69%	15%	4%	5%	23391	0.026	b7b9e26865a090a7c1ecb069e5c17ed8	[ "A: Antibiotics", "B: Cessation of nitrofurantoin", "C: Glucocorticoids", "D: Intravenous loop diuretics", "E: Scheduled nebulized bronchodilators" ]	B: Cessation of nitrofurantoin
85	aug-04-2011	This lesion developed on the chest of a 35-year-old man during treatment for a respiratory tract infection. What is the diagnosis?	yes	4%	10%	43%	34%	9%	105858	0.128	386a6c59e402c490027afc14a433b07c	[ "A: Acute urticaria", "B: Drug-induced pemphigus", "C: Erythema annulare", "D: Fixed drug eruption", "E: Stevens-Johnson syndrome" ]	D: Fixed drug eruption
86	aug-04-2016	A man presented with new peripheral edema. What diagnosis does his chest X-ray suggest?	yes	6%	8%	2%	32%	51%	106508	0.071	519991e9a255071495ba8ce81a9d7291	[ "A: Superior vena cava syndrome", "B: Dilated thoracic aorta", "C: Right middle lobe pneumonia", "D: Cardiac tamponade", "E: Giant right atrium" ]	E: Giant right atrium
87	aug-04-2022	A 71-year-old man presented with an 8-year history of enlarging nodules on his nose. On physical examination, he had painless, violaceous, indurated nodules on his nose, ears, fingers, and toes. Computed tomography of the chest revealed hilar and mediastinal lymphadenopathy. Skin biopsy showed non-caseating granulomas. What is the most likely diagnosis?	yes	15%	17%	36%	12%	20%	69090	0.103	ce2f2a1af407453448aee5c550096885	[ "A: Entomophthoramyocosis", "B: Leprosy", "C: Lupus pernio", "D: Lupus vulgaris", "E: Rhinophyma" ]	C: Lupus pernio
88	aug-05-2010	An 18-year-old woman presented with visual loss in the right eye. What diagnosis is suggested by this finding on ophthalmoscopy?	yes	5%	13%	17%	20%	45%	74241	0.078	8dbecc629f6cde0f86a99a83adb85a81	[ "A: Cystic fibrosis", "B: Marfan syndrome", "C: Sickle cell disease", "D: Tay-Sachs disease", "E: Von Hippel-Lindau disease" ]	E: Von Hippel-Lindau disease
89	aug-05-2021	A 62-year-old woman with recent travel to Colombia presented with pruritic, draining nodules with a central punctum on her back and buttocks. The lesions were unchanged after a trial of antibiotics. What is the most likely diagnosis?	yes	23%	10%	14%	36%	17%	110076	0.104	8251c1020681d077eefb61aadb0c070a	[ "A: Cutaneous leishmaniasis", "B: Epidermoid cyst", "C: Furunculosis", "D: Myiasis", "E: Tungiasis" ]	D: Myiasis
90	aug-06-2009	This 6-week old presented with scrotal pain. What is the diagnosis?	yes	8%	17%	30%	4%	41%	123854	0.095	10d4872b0acd0d53709eb9ad210918b3	[ "A: Bilateral cryptorchidism", "B: Bilateral inguinal hernias", "C: Isolated right hydrocele", "D: Left retractile testis", "E: Left testicular torsion" ]	E: Left testicular torsion
91	aug-06-2015	Which of the following is the least likely differential diagnosis associated with this image finding?	no	51%	13%	10%	14%	11%	89280	0.06	8cf8c3bfa9c1346b7bb9a42fb246f981	[ "A: Pulmonary hypertension", "B: Neoplasm", "C: Vasculitis", "D: Septic emboli", "E: Infection" ]	A: Pulmonary hypertension
92	aug-06-2020	A 60-year-old woman presented to an oral surgery clinic with gum swelling. She had associated bleeding while brushing her teeth. She had a history of colorectal cancer treated with surgery and chemotherapy. On examination, a large, nontender, pedunculated mass was noted. What is the diagnosis?	yes	11%	42%	21%	16%	10%	88448	0.086	e29c45036b05a659416c13466f811b3d	[ "A: Zimmerman-Laband syndrome", "B: Metastasis of colorectal cancer", "C: Gingival hyperplasia secondary to chemotherapy", "D: Alveolar soft part sarcoma", "E: Irritation fibroma" ]	B: Metastasis of colorectal cancer
93	aug-07-2008	This 35-year-old pet shop worker developed progressively spreading nodular lesions. He was afebrile. What is the most likely causative organism?	yes	7%	15%	39%	21%	17%	144757	0.094	c4763c4e290bf803f392a12c3a1ac5ce	[ "A: Acinetobacter baumannii", "B: Erysipelothrix rhusiopathiae", "C: Mycobacterium marinum", "D: Pasteurella multocida", "E: Staphylococcus epidermidis" ]	C: Mycobacterium marinum
94	aug-07-2014	What is the most likely diagnosis?	no	7%	14%	12%	13%	55%	93309	0.052	eb8b5c72ce584582b95a2708b1e96574	[ "A: Mucocele", "B: Necrotizing sialometaplasia", "C: Periapical abscess", "D: Periodontal abscess", "E: Syphilitic gumma" ]	E: Syphilitic gumma
95	aug-08-2013	What is the diagnosis in this 42-year-old man with bone pain?	yes	11%	28%	19%	34%	8%	84108	0.138	d26b5f419f68d0aee357d36945b33422	[ "A: Hypervitaminosis A", "B: Gaucher's disease", "C: Multiple myeloma", "D: Osteopetrosis", "E: Thalassemia minor" ]	B: Gaucher's disease
96	aug-08-2019	A 79-year-old man with a history of ischemic cardiomyopathy and chronic kidney disease presented 1 month after a transcatheter aortic-valve replacement (TAVR) with a serum creatinine level of 4.0 mg per deciliter (350 umol per liter), up from a baseline of 1.6 mg per deciliter (140 umol per liter). Renal biopsy is shown. What is the most likely diagnosis?	yes	10%	17%	13%	49%	12%	55114	0.066	077347bc16e778f4ad03f232cf8a8957	[ "A: Calcium oxalate deposition", "B: Ischemic acute tubular necrosis", "C: Renal artery infarction", "D: Cholesterol crystal embolization", "E: Cryoglobulinemic vasculitis" ]	D: Cholesterol crystal embolization
97	aug-09-2007	What is the diagnosis?	no	15%	55%	5%	10%	14%	137802	0.051	6e1b161166db53e9133c7d08c96cdeab	[ "A: Molluscum contagiosum", "B: Pearly penile papules", "C: Secondary syphilis", "D: Obstruction of smegma-producing gland", "E: Condyloma acuminatum" ]	B: Pearly penile papules
98	aug-09-2012	What diagnosis is suggested by the results of this coronary angiogram?	yes	3%	15%	7%	48%	27%	82891	0.074	f40315d5f4367e76481a8f636ddd887f	[ "A: Diabetes mellitus", "B: Fibromuscular dysplasia", "C: Marfan syndrome", "D: Polyarteritis nodosa", "E: Takayasu arteritis" ]	D: Polyarteritis nodosa
99	aug-09-2018	A 39-year-old man presented to the emergency department with anorexia, nausea, vomiting, oliguria, and diffuse deposits on his skin. The physical exam findings are associated with what underlying disease?	yes	59%	10%	14%	9%	8%	69493	0.042	021172e7aadf571a66f39d897e9e2444	[ "A: End-stage renal disease", "B: Acute myeloid leukemia", "C: Sarcoidosis", "D: End-stage liver disease", "E: Tuberculosis" ]	A: End-stage renal disease
100	aug-10-2006	A 25-year-old bodybuilder presented with a tender, erythematous mass in the left upper arm. What is the most likely diagnosis?	yes	30%	40%	20%	5%	5%	90070	0.099	4e38bd8e44f0dcdde34efe8592d16dad	[ "A: Ruptured biceps tendon", "B: Abscess", "C: Axillary vein thrombosis", "D: Glenohumeral joint dislocation", "E: Osteosarcoma" ]	B: Abscess

1

apr-01-2010

This 4-year-old boy presented with a 5-day history of mild fever and malaise and a 3-day history of rash. What is the diagnosis?

yes

12%

62%

10%

11%

6%

96521

0.037

22a308b8983b3dcb60375bac04347a26

[ "A: Erythema infectiosum", "B: Hand, foot, and mouth disease", "C: Kawasaki disease", "D: Measles", "E: Pityriasis rosea" ]

B: Hand, foot, and mouth disease

2

apr-01-2021

A 5-year-old girl presented with a 4-week history of painful swelling on both sides of her lower abdomen. Six weeks before presentation, her parents removed a tick they found buried in her umbilicus. Five days after this she developed fevers. What is the diagnosis?

yes

17%

16%

31%

21%

16%

130077

0.12

710db3c4b917d478ee231f50416c16f5

[ "A: Ehrlichiosis", "B: Babesiosis", "C: Tularemia", "D: Lyme disease", "E: Rocky Mountain spotted fever" ]

C: Tularemia

3

apr-02-2009

What is the diagnosis?

no

6%

39%

31%

10%

14%

129386

0.1

0d08dbca65e634e1efcb54348c2e6f84

[ "A: Carcinoid syndrome", "B: Dermatomyositis", "C: Endocarditis", "D: Lichen planus", "E: Porphyria" ]

B: Dermatomyositis

4

apr-02-2015

What is the most likely diagnosis in this 65-year-old woman with a 7-day history of throat pain and difficulty swallowing?

yes

40%

27%

6%

20%

7%

113962

0.096

76643769fc511d50976faed3b2c882a9

[ "A: Epiglottitis", "B: Foreign body aspiration", "C: Peritonsillar abscess", "D: Retropharyngeal abscess", "E: Thyroid nodule" ]

A: Epiglottitis

5

apr-02-2020

A 2-year-old boy who was born at full term and had been delivered with the assistance of forceps presented to the otolaryngology clinic with an 18-month history of flushing on his right cheek that appeared when he ate. Flushing appeared when he ate strawberries in the clinic and was not associated with pain, pruritus, sweating, or respiratory symptoms. The findings from the remainder of the examination were normal. What is the underlying condition?

yes

61%

15%

10%

7%

57038

0.039

758ff9dd0c5c51b25b8751a4c40d5abd

[ "A: Frey’s syndrome", "B: Food allergy", "C: Rosacea", "D: Autonomic epilepsy", "E: Carcinoid syndrome" ]

A: Frey’s syndrome

6

apr-03-2008

A patient with this tomogram would be most likely to present with which one of the following signs?

yes

23%

37%

12%

15%

118628

0.1

a9fefa553b6b8c3a599e4763a12f8333

[ "A: Uniocular blindness", "B: Hemiplegia", "C: Alexia without agraphia", "D: Hemiballismus", "E: Internuclear ophthalmoplegia" ]

B: Hemiplegia

7

apr-03-2014

What is the diagnosis?

no

11%

8%

61%

6%

14%

77860

0.039

82081ef87459ddf47974f34e98609389

[ "A: Empyema", "B: Lymphangioleiomyomatosis", "C: Paraesophageal hernia", "D: Pericardial effusion", "E: Plombage" ]

C: Paraesophageal hernia

8

apr-04-2013

What is the diagnosis?

no

8%

23%

8%

48%

13%

75732

0.071

265de82ee3128df8baf91b1398bacb40

[ "A: Adrenal cancer", "B: Echinococcal infection", "C: Meckel's diverticulitis", "D: Pneumatosis intestinalis", "E: Trichobezoar" ]

D: Pneumatosis intestinalis

9

apr-04-2019

A 48-year-old man presented to the ophthalmology clinic with a 1-week history of pain, double vision, and blurred vision in his left eye. What is the abnormality depicted here?

yes

75%

9%

8%

1%

6%

64348

0.016

ee7bbc90717eb551fba5f8be9abdc66a

[ "A: Separation of the iris", "B: Separation of the pupil", "C: Separation of the lens", "D: Normal eye finding", "E: Separation of the sclerae" ]

A: Separation of the iris

10

apr-05-2007

This 9-kg liver was removed at the time of liver transplantation. What is the diagnosis?

yes

14%

7%

12%

63%

5%

114695

0.036

5240a28586c31856b7714ea8c42a4171

[ "A: Macronodular cirrhosis", "B: Hepatocellular carcinoma", "C: Echinococcosis", "D: Polycystic liver disease", "E: Trophoblastic tumor" ]

D: Polycystic liver disease

11

apr-05-2012

What is the diagnosis?

no

7%

58%

26%

4%

5%

95890

0.051

6a21a1d2ee88735c71dc42801b5bdab8

[ "A: Granulomatosis with polyangiitis (Wegener's)", "B: Lepromatous leprosy", "C: Neurofibromatosis type 1", "D: Sarcoidosis", "E: Tertiary syphilis" ]

B: Lepromatous leprosy

12

apr-05-2018

A 21-year-old woman presented to the emergency department with an 8-month history of swelling and pain in the right thigh. MRI of the right leg revealed a large periosteal femoral mass and thrombus in the right femoral vein, for which she received anticoagulation therapy. The patient subsequently experienced dyspnea and pleuritic chest pain, and a chest x-ray was done. What is the likely diagnosis?

yes

9%

14%

16%

43%

18%

186500

0.082

f57669f6e808686fe7d8a5836a535c3e

[ "A: Pulmonary embolism", "B: Pulmonary sarcoidosis", "C: Eosinophilic granulomatosis with polyangiitis", "D: Chondroblastic osteosarcoma", "E: Miliary tuberculosis" ]

D: Chondroblastic osteosarcoma

13

apr-06-2006

This 36-year-old man has undergone renal transplantation and parathyroidectomy. What is the most likely cause of the changes in his hands?

yes

44%

14%

37%

3%

2%

88222

0.094

54c6d230737ded9ff7dc98eafda961ec

[ "A: Pseudoclubbing", "B: Albright's hereditary osteodystrophy", "C: Hypertrophic osteoarthropathy", "D: Yellow nail syndrome", "E: Psoriasis" ]

A: Pseudoclubbing

14

apr-06-2017

A 3-year-old boy presented with a 6-month history of gross hematuria, and was found to have kidney, bladder, and ureteral stones. Which of the following factors predisposed this boy to genitourinary stone formation?

yes

10%

63%

9%

8%

69416

0.034

1ca599712907e3340bf93e17f5c36ead

[ "A: Phenylketonuria", "B: Ornithine transcarbamylase deficiency", "C: Primary hyperoxaluria", "D: Acid maltase deficiency (Pompe disease)", "E: Pyruvate kinase deficiency" ]

C: Primary hyperoxaluria

15

apr-06-2023

An 87-year-old man with chronic kidney disease, hypertension, and atrial fibrillation presented to the emergency department with a 3-day history of constipation and lower abdominal pain. Physical examination was notable for abdominal distention and tenderness to palpation of the right lower quadrant without rebound or guarding. A plain radiograph of the abdomen is shown. What is the most likely diagnosis?

yes

57%

6%

5%

23%

10%

30921

0.051

54f083d5b14a455dfbb4744b94ea466b

[ "A: Cecal volvulus", "B: Constipation", "C: Hiatal hernia", "D: Ogilvie’s Syndrome (acute colonic pseudo-obstruction)", "E: Small bowel obstruction" ]

A: Cecal volvulus

16

apr-07-2011

What is the diagnosis?

no

16%

7%

8%

11%

58%

99378

0.045

4c746a45fa8ec7bb530dd9367c63a806

[ "A: Dermatitis herpetiformis", "B: Impetigo", "C: Measles", "D: Secondary syphilis", "E: Varicella" ]

E: Varicella

17

apr-07-2016

What is the most likely diagnosis in a patient with dysarthria and gait instability and this finding?

yes

14%

18%

10%

12%

45%

93055

0.076

57e364ea780e466be3ba61d7bc63afbf

[ "A: Huntington's disease", "B: Wilson's disease", "C: Middle cerebral artery stroke", "D: NMDA receptor encephalitis", "E: Metronidazole-associated encephalopathy" ]

E: Metronidazole-associated encephalopathy

18

apr-07-2022

A 30-year-old man with Crohn's disease presented to the dermatology clinic with multiple painful ulcers in his groin and perineal area, as well as an ongoing Crohn's disease flare with fatigue, abdominal pain, and bloody diarrhea. Physical examination of the skin showed deep, linear erosions across the perineum and inguinal folds, on the scrotum and penile shaft, and in the intergluteal cleft. Which of the following is the most likely etiology underlying the genital ulcers?

yes

15%

64%

6%

8%

31111

0.033

0da80e1e80aba8308f4aee22f58152f7

[ "A: Ecthyma gangrenosum", "B: Knife-cut ulcers from Crohn’s disease", "C: Lichen sclerosus", "D: Linear IgA disease", "E: Pemphigus foliaceus" ]

B: Knife-cut ulcers from Crohn’s disease

19

apr-08-2010

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

yes

9%

10%

21%

13%

47%

103941

0.072

3cbdda08793d8e9ee94fcc609a43319b

[ "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" ]

E: Right sixth cranial nerve palsy

20

apr-08-2021

A 68-year-old woman presented to clinic with a 40-year history of worsening hyperkeratotic non-painful, non-pruritic papules and plaques on her hands and feet. Her mother, son, and granddaughter had similar lesions. What is the diagnosis?

yes

4%

72%

5%

11%

7%

71861

0.02

b298e5a9c5c45b56c98c53003ea7cd6d

[ "A: Erythema multiforme", "B: Punctate palmoplantar keratoderma", "C: Incontinentia pigmenti", "D: Tuberous sclerosis", "E: Syphilis" ]

B: Punctate palmoplantar keratoderma

21

apr-09-2009

What term is used to describe this finding?

no

9%

8%

9%

62%

12%

113468

0.036

256b9edd63cdd052280124700bfa2dd4

[ "A: Arc eye", "B: Asthenopia", "C: Choroideremia", "D: Coloboma", "E: Corectopia" ]

D: Coloboma

22

apr-09-2015

What is the most likely cause of this physical exam finding in a 65-year-old woman undergoing treatment for breast cancer?

yes

9%

48%

24%

11%

8%

90516

0.071

d6d7552e25e6dde7b89e578c6e9301c2

[ "A: Vitamin E deficiency", "B: Chemotherapy", "C: Scleroderma", "D: Chronic inflammatory demyelinating polyneuropathy", "E: Mercury toxicity" ]

B: Chemotherapy

23

apr-09-2020

A 45-year-old woman was referred to the outpatient clinic after multiple hepatic lesions were incidentally noted on imaging. She had no related symptoms. The physical examination and laboratory tests were all normal. Enhanced computed tomography of the abdomen had shown multiple small, hypodense, nonenhancing nodules throughout the liver. Magnetic resonance imaging with cholangiopancreatography revealed multiple small, T2-weighted, hyperintense cystic nodules in the liver, without biliary duct communication, creating a "starry sky" appearance. What is the diagnosis?

yes

4%

48%

15%

10%

23%

64551

0.071

9749b77fb59101c21714b7476446d40d

[ "A: Acute hepatitis", "B: Multiple biliary hamartomas", "C: Malignant hydatidosis", "D: Multiple liver metastases", "E: Caroli syndrome" ]

B: Multiple biliary hamartomas

24

apr-10-2008

This rash appeared following treatment for leukemia. What is the diagnosis?

yes

18%

17%

4%

41%

21%

127715

0.091

7c48805e409ecfaf6137fc38e9b103cc

[ "A: Cryoglobulinemia", "B: Leukemia cutis", "C: Herpes zoster", "D: Graft-versus-host disease", "E: Urticaria pigmentosa" ]

D: Graft-versus-host disease

25

apr-10-2014

What is the diagnosis?

no

30%

20%

8%

30%

11%

116652

0.168

16c5f7db46777c341e3fd102bcc5c09f

[ "A: Blastomycosis", "B: Celiac disease", "C: Down's syndrome", "D: Hyperparathyroidism", "E: IgA nephropathy" ]

B: Celiac disease

26

apr-11-2013

What is the diagnosis?

no

49%

13%

8%

26%

4%

75898

0.071

fd164aacec343bdd070cebdfdc793fa0

[ "A: Amelanotic melanoma", "B: Angioma", "C: Dermal nevus", "D: Pyogenic granuloma", "E: Wart" ]

A: Amelanotic melanoma

27

apr-11-2019

A 35-year-old man presented to the emergency department with a 2-day history of abdominal pain, headache, and brown urine. He was alert and oriented to time, place, and self. He had no purpura or petechiae. Laboratory evaluation revealed a hemoglobin level of 8.6 g per deciliter (normal range, 13.7 to 17.5) and a platelet count of 6000 per cubic millimeter (normal range, 140,000 to 370,000). Levels of indirect bilirubin and lactate dehydrogenase were elevated, haptoglobin was undetectable, and the serum creatinine level was 1 mg per deciliter (88 umol per liter; normal range, 0.6 to 1.3 mg per deciliter [57 to 115 umol per liter]). Test results for infection with the human immunodeficiency virus were negative. A peripheral-blood smear showed numerous schistocytes. What is the diagnosis?

yes

13%

43%

8%

24%

12%

86397

0.084

825aefb4c6e86911a1a9ff4f6dc90798

[ "A: Idiopathic thrombocytopenic purpura", "B: Thrombotic thrombocytopenic purpura", "C: Pseudotrombocytopenia", "D: Hemolytic-uremic syndrome", "E: Excessive splenic platelet sequestration" ]

B: Thrombotic thrombocytopenic purpura

28

apr-12-2007

What is the diagnosis?

no

6%

36%

8%

12%

38%

115281

0.108

f3ba23e4129701bd68c7127ef14937d0

[ "A: Intracranial hemorrhage", "B: Osteoma", "C: Neurocysticercosis", "D: Arachnoid cyst", "E: Meningioma" ]

E: Meningioma

29

apr-12-2012

What is the diagnosis?

no

6%

13%

11%

17%

53%

87068

0.056

5b26f982458eed01a6ae19dc169b6018

[ "A: Cryptorchidism", "B: Femoral-artery pseudoaneurysm", "C: Iliopectineal bursitis", "D: Inguinal hernia", "E: Metastatic inguinal lymphadenopathy" ]

E: Metastatic inguinal lymphadenopathy

30

apr-12-2018

A 70-year-old man presented to the ophthalmology clinic with a 1-year history of progressive bluish discoloration of the sclerae of both eyes. He reported no ocular discomfort or blurry vision. He had previously received a diagnosis of an inflammatory arthritis for which he had been taking minocycline for more than 15 years. Examination was notable for bluish discoloration of the sclera of both eyes and pinnae of both ears. Ophthalmologic examination was otherwise normal. What is the diagnosis?

yes

13%

65%

8%

6%

68753

0.031

e2aa978d299aeeab7c99907e8fccf89f

[ "A: Osteogenesis imperfecta", "B: Minocycline-induced pigmentation", "C: Ehlers-Danlos syndrome", "D: Primary acquired melanosis", "E: Conjunctival melanoma" ]

B: Minocycline-induced pigmentation

31

apr-13-2006

This 46-year-old woman developed pruritus and similar papular lesions over her axillae, groin, and buttocks. What is the most likely diagnosis?

yes

3%

4%

5%

8%

80%

66795

0.01

fab61e3d1fc500942aa0dc8eb57befd7

[ "A: Pilonidal sinus", "B: Psoriasis", "C: Impetigo", "D: Dermatomyositis", "E: Scabies" ]

E: Scabies

32

apr-13-2017

A 6-year-old girl presented with short stature, impaired hearing, and vision loss at 2 years of age. A radiograph of her wrists show the following features. What is the diagnosis?

yes

13%

46%

18%

14%

9%

96827

0.074

8468a24b04b771116b00ca8854f7af17

[ "A: Lead poisoning", "B: Osteopetrosis", "C: Fibrous dysplasia", "D: Hypoparathyroidism", "E: Hypervitaminosis D" ]

B: Osteopetrosis

33

apr-13-2023

A 34-year-old woman with tobacco use disorder was referred to the pulmonary clinic for worsening dyspnea and dry cough. She had chronic hypoxemic respiratory failure of unknown cause, requiring supplemental oxygen. Computed tomography of the chest showed diffuse ground-glass opacities and areas of peripheral consolidation but no basilar reticulations or honeycombing. Bronchoalveolar lavage was not diagnostic, so surgical lung biopsy was performed. Histopathological analysis showed extensive alveolar filling with pigment-laden macrophages. What is the most likely diagnosis?

yes

39%

12%

10%

15%

23%

38273

0.094

d48f7b5997ceccd9ba035c99e13d6f91

[ "A: Desquamative interstitial pneumonia", "B: Diffuse alveolar hemorrhage", "C: Idiopathic pulmonary fibrosis", "D: Lipoid pneumonia", "E: Pulmonary alveolar proteinosis" ]

A: Desquamative interstitial pneumonia

34

apr-14-2011

What is the most likely diagnosis?

no

17%

6%

9%

29%

39%

127332

0.099

b7f21b63216b4cf6bedd1d950acdc183

[ "A: Calciphylaxis", "B: Factor V Leiden", "C: Protein C deficiency", "D: Scleroderma", "E: Waldenstrom's macroglobulinemia" ]

E: Waldenstrom's macroglobulinemia

35

apr-14-2016

What is the most likely cause of this physical finding?

no

8%

59%

12%

11%

9%

107013

0.042

a93c1db4f0e8d736eb04d0f2c6d941a1

[ "A: Ascariasis", "B: Esophagogastric bypass", "C: Hirschsprung's disease", "D: Acute intestinal pseudo-obstruction", "E: Cutaneous leishmaniasis" ]

B: Esophagogastric bypass

36

apr-14-2022

A 64-year-old man with metastatic lung adenocarcinoma who had recently started high-dose steroids for malignant spinal cord compression developed an itchy rash and diarrhea. He had a 3-year history of intermittent peripheral eosinophilia of unknown cause. What is the most likely diagnosis?

yes

21%

14%

40%

16%

10%

81969

0.092

ec548f83dbd871577fc45ad94b286ce3

[ "A: Cutaneous larva migrans", "B: Cutaneous schistosomiasis", "C: Larva currens from Strongyloides", "D: Lichen striatus", "E: Scabies" ]

C: Larva currens from Strongyloides

37

apr-15-2010

What is the diagnosis?

no

46%

26%

14%

8%

6%

88766

0.078

e4782a5eca3fe76a3d4caaab223c76fc

[ "A: Duodenal perforation", "B: Emphysematous pyelonephritis", "C: Perinephric cyst", "D: Situs inversus", "E: Ureterocele" ]

A: Duodenal perforation

38

apr-15-2021

A 27-year-old primigravid woman was admitted with new-onset diabetes and hypertension at 32 weeks of gestation. She had worsening proximal muscle weakness, striae, and facial plethora for several months. Physical examination showed striae over the abdomen, breasts, and dorsal and supraclavicular fat pads. Laboratory studies were notable for a potassium of 2.9 mmol per liter (reference range, 3.5 to 5.5) and a urine protein:creatinine ratio of 24 (reference value, <30). What is the most likely diagnosis?

yes

13%

9%

24%

50%

5%

104566

0.067

0189828491c96333a75abc9ecf1ced51

[ "A: Eclampsia", "B: Hyperthyroidism", "C: Addison’s disease", "D: Adrenal mass", "E: Parathyroid mass" ]

D: Adrenal mass

39

apr-16-2009

What is the diagnosis?

no

11%

53%

7%

19%

10%

116464

0.057

b2afd7dcdf273204c5a638dcf8a668a5

[ "A: Epidermolysis bullosa", "B: Hereditary hemorrhagic telangiectasia", "C: Neurofibromatosis", "D: Peutz-Jeghers syndrome", "E: Scleroderma" ]

B: Hereditary hemorrhagic telangiectasia

40

apr-16-2015

What is the most likely diagnosis in this 50-year-old woman with atrial fibrillation who sees halos around lights?

yes

5%

19%

14%

6%

56%

84438

0.051

68d4d486fc43cf86a2a1d13e4953f709

[ "A: Early cataract", "B: Herpes simplex virus keratitis", "C: Digoxin-associated visual disturbance", "D: Amaurosis fugax", "E: Amiodarone-induced vortex keratopathy" ]

E: Amiodarone-induced vortex keratopathy

41

apr-16-2020

A 71-year-old man was hospitalized with altered mental status progressing over the preceding 3 weeks. The patient had a recent diagnosis of adenocarcinoma of the colon with known metastatic lesions in the lung and bones. A gadolinium-enhanced magnetic resonance image of the brain was performed and is shown. What is the most likely diagnosis?

yes

12%

24%

47%

9%

7%

96161

0.073

93f05a8fde182f73c47aaeff6fa08234

[ "A: Group D streptococcus abscesses", "B: Neurocysticercosis", "C: Metastatic adenocarcinoma", "D: Tuberculosis", "E: Primary central nervous system lymphoma" ]

C: Metastatic adenocarcinoma

42

apr-17-2008

What is the diagnosis?

no

36%

3%

10%

39%

12%

128105

0.117

e4f8c2d40e7c1a7b28257eacfcc06aa7

[ "A: Babesiosis", "B: Iron deficiency anemia", "C: Hereditary spherocytosis", "D: Malaria", "E: Sideroblastic anemia" ]

A: Babesiosis

43

apr-17-2014

What is the diagnosis?

no

6%

24%

13%

52%

75184

0.062

dc6ccc761d00369cf1bf69d8ac1e542f

[ "A: Blepharitis", "B: Entropion", "C: Eyelid wart", "D: Keratoconjunctivitis sicca", "E: Vernal keratoconjunctivitis" ]

E: Vernal keratoconjunctivitis

44

apr-18-2013

What diagnosis explains these lesions that developed after acupuncture to the area?

yes

20%

27%

25%

7%

20%

106232

0.144

4547d8c5c2e94ff85d8c80e5df15e423

[ "A: Herpetic whitlow", "B: Nummular eczema", "C: Psoriasis", "D: Ringworm", "E: Scabies" ]

C: Psoriasis

45

apr-18-2019

A 60-year-old woman presented to the ophthalmology clinic after noticing central blind spots in the visual fields of both eyes. She had a history of rheumatoid arthritis, which had been treated with hydroxychloroquine for 14 years. The retinal examination showed the pattern below. What is the most likely underlying cause of this abnormality?

yes

5%

68%

13%

5%

8%

42782

0.026

ce60c65aa040c398cdcff55a4d15564f

[ "A: Rheumatoid arthritis", "B: Hydroxychloroquine toxicity", "C: Age-related macular degeneration", "D: Type 2 diabetes", "E: Bardet-Biedl syndrome" ]

B: Hydroxychloroquine toxicity

46

apr-19-2007

What is the diagnosis?

no

9%

13%

5%

56%

17%

111961

0.05

16a7e101f49142f45a3afd960c51caff

[ "A: Syphilis", "B: Phenytoin exposure", "C: Marfan syndrome", "D: Torus palatinus", "E: Kaposi sarcoma" ]

D: Torus palatinus

47

apr-19-2012

Which of these medications, used to treat this patient's glioblastoma multiforme, is most likely to have contributed to this complication?

yes

11%

43%

10%

17%

18%

96463

0.082

16eaac00ee2aaa67a75f31858e95c9bc

[ "A: Acetazolamide", "B: Dexamethasone", "C: Levetiracetam", "D: Temozolomide", "E: Topotecan" ]

B: Dexamethasone

48

apr-19-2018

A 74-year-old woman presented to the emergency department with a 3-day history of lower abdominal pain, nausea, and vomiting. A plain-film radiograph of the abdomen showed marked dilatation of bowel loops and abrupt termination of gas within the descending colon, referred to as a colon cutoff sign.

yes

13%

35%

14%

24%

128944

0.107

028d27a9c5ac00a54b366263382f9bc0

[ "A: Diaphragmatic hernia", "B: Acute pancreatitis", "C: Toxic shock syndrome", "D: Lead poisoning", "E: Crohn’s disease" ]

B: Acute pancreatitis

49

apr-20-2006

This 63-year-old man with a 10-year history of progressive neck enlargement noted a sudden increase in the size of the swelling on the left side. What is the most likely diagnosis?

yes

16%

8%

37%

17%

22%

92009

0.101

d830b4550dad00fbdba162d661c8c2dd

[ "A: Superior vena cava syndrome", "B: Scrofula", "C: Bleeding into a thyroid nodule", "D: Non-hodgkins lymphoma", "E: Follicular thyroid carcinoma" ]

C: Bleeding into a thyroid nodule

50

apr-20-2017

A 30-year-old man presented with this lesion on his right lower eyelid that had grown over 3 days. Two weeks before his presentation, a cyst had ruptured on the same eyelid. What is the diagnosis?

yes

17%

4%

5%

62%

12%

84701

0.038

525b57975503d190a322a94367a3b5f3

[ "A: Squamous papilloma", "B: Amelanotic melanoma", "C: Squamous-cell carcinoma", "D: Pyogenic granuloma", "E: Suture granuloma" ]

D: Pyogenic granuloma

51

apr-20-2023

A 60-year-old left-handed woman presented to the emergency department with pain in her left forearm. The arm was swollen and tender, especially with passive pronation and supination. The overlying skin was intact, and the results of neurovascular examination were normal. Radiographs of the left forearm were performed (upper image, anteroposterior view; lower image, lateral view). The findings should raise concern for which contributory factor?

yes

42%

15%

12%

19%

12%

41942

0.085

d6ca50da3aede1ecf8fd6047370ff76f

[ "A: Assault", "B: Fall", "C: Malignancy", "D: Osteoporosis", "E: Repetitive strain" ]

A: Assault

52

apr-21-2011

What is the diagnosis?

no

24%

29%

11%

16%

20%

153754

0.164

998146f48ca9e7e68b23749f4231b76b

[ "A: Erythema marginatum", "B: Erythema multiforme", "C: Pityriasis rosea", "D: Tinea versicolor", "E: Tuberculoid leprosy" ]

E: Tuberculoid leprosy

53

apr-21-2016

What is the most likely diagnosis in an elderly woman with dyspnea and these findings?

yes

9%

64%

8%

10%

69714

0.032

ae6d814adb970970bd69e848e76e59ef

[ "A: Esophageal tumor", "B: Vein-graft aneurysms", "C: Thymoma", "D: Liposarcoma", "E: Hemangioma" ]

B: Vein-graft aneurysms

54

apr-21-2022

A 56-year-old man with sickle hemoglobin C disease and proliferative sickle cell retinopathy presented for a routine eye examination. He was asymptomatic. What is seen on this examination of the anterior segment of the eye?

yes

24%

15%

33%

16%

12%

53751

0.114

2f46989159d4af54c5a73fc6a5550fbf

[ "A: Bilateral acute depigmentation of the iris (BADI)", "B: Cornea verticillata", "C: Iris atrophy", "D: Mutton-fat keratic precipitates", "E: Sunflower cataract" ]

C: Iris atrophy

55

apr-22-2010

What is the most likely diagnosis?

no

16%

7%

56%

11%

10%

103467

0.049

bdb4e140be3fb7dd37f1f8f1c6e5d6b1

[ "A: End-stage renal disease", "B: Graves' disease", "C: Iron deficiency", "D: Pseudohypoparathyroidism", "E: Sarcoidosis" ]

C: Iron deficiency

56

apr-22-2021

A 48-year-old man presented with a 2-week history of fever, shortness of breath, and painful skin lesions with blistering. His temperature was 39.2°C. What is the diagnosis?

yes

20%

23%

18%

26%

13%

180013

0.138

45424b397ee407c218c4b2396e917fcc

[ "A: Weil’s disease", "B: Staphylococcal scalded skin syndrome", "C: Legionnaires' disease", "D: Leprosy", "E: Lyme disease" ]

D: Leprosy

57

apr-23-2009

What is the diagnosis?

no

24%

8%

33%

15%

20%

205366

0.151

fdccd3d3100a46d2bca139711e1d269b

[ "A: Hypercholesterolemia", "B: Leukemia", "C: Lichen planus", "D: Pompe's disease", "E: Psoriasis" ]

A: Hypercholesterolemia

58

apr-23-2015

The following physical exam finding is most commonly associated with which one of the following?

no

49%

18%

16%

12%

6%

97279

0.067

d090fe75d278f5015c71bc3652d68aef

[ "A: Chronic kidney disease", "B: Thyroid dysfunction", "C: End-stage liver disease", "D: Pulmonary disease", "E: Systemic infection" ]

A: Chronic kidney disease

59

apr-23-2020

An 83-year-old woman presented to the gastroenterology clinic with dysphagia and regurgitation that occurred with every meal associated with postprandial chest pain. For several years she had difficulty swallowing both solids and liquids. Barium esophagram is shown. What is the diagnosis?

yes

17%

13%

9%

43%

100982

0.082

3f67e08c03b8af5579802bcd92cc14b4

[ "A: Scleroderma", "B: Esophageal stricture", "C: Esophageal web", "D: Esophageal carcinoma", "E: Achalasia" ]

E: Achalasia

60

apr-24-2008

What is the diagnosis?

no

9%

26%

16%

7%

42%

105778

0.089

a814ba86cc8362c62a5fdb6df1507310

[ "A: Central retinal artery occlusion", "B: Diabetic papillopathy", "C: Ocular toxoplasmosis", "D: Optic neuritis", "E: Malignant hypertension" ]

E: Malignant hypertension

61

apr-24-2014

What is the cause of this new skin lesion in this patient whose blood CD4+ cell count was 20 per cubic millimeter (1%) following treatment for chronic lymphocytic leukemia?

yes

17%

6%

31%

23%

22%

201064

0.122

ba04fd43f42eefe641a9d1a70ef0fea6

[ "A: Bacillary angiomatosis", "B: Bullous impetigo", "C: Cryptococcosis", "D: Kaposi's sarcoma", "E: Verruca vulgaris" ]

C: Cryptococcosis

62

apr-25-2013

In addition to neurofibromatosis, what other examination finding would you expect for this patient?

yes

13%

12%

56%

9%

10%

71010

0.049

96b1bd987cc53d56b3d1fc50735b65a8

[ "A: Aortic regurgitation", "B: Chvostek sign", "C: Lisch nodules", "D: Thyroid bruit", "E: Web neck" ]

C: Lisch nodules

63

apr-25-2019

A 37-year-old man presented with a 4-year history of excessive sweating, headaches, and joint pain. His wife had also noticed increasing skin folds on his scalp. What is the most likely diagnosis?

yes

38%

19%

17%

11%

16%

171218

0.097

397f0a7a40a0bcbc2d3c052b266a4cbc

[ "A: Acromegaly", "B: Amyloidosis", "C: Systemic sclerosis", "D: Hypogonadism", "E: Sarcoidosis" ]

A: Acromegaly

64

apr-26-2007

In what vessel is this patient's dialysis catheter?

yes

11%

32%

33%

18%

6%

107164

0.12

eb240cc05f3d774a184cc77bddfc3297

[ "A: Left axillary vein", "B: Left internal mammary vein", "C: Left-sided superior vena cava", "D: Azygous vein", "E: Highest intercostal vein" ]

C: Left-sided superior vena cava

65

apr-26-2012

What is the most likely infecting organism in this patient with prostatitis?

yes

28%

12%

15%

33%

93945

0.136

db1159ded67405646b4ec8ea1ed8e5f7

[ "A: Blastomyces dermatitidis", "B: Escherichia coli", "C: Histoplasma capsulatum", "D: Pseudomonas aeruginosa", "E: Staphylococcus aureus" ]

A: Blastomyces dermatitidis

66

apr-26-2018

A 31-year-old man presented to the emergency department with a 2-week history of left ear swelling. He had similar episodes over the past 2 years, and a 6-month history of weight loss, fatigue, and generalized aches. Physical exam revealed a swollen and tender ear, costochondral joints, and left knee. Lab tests showed an elevated erythrocyte sedimentation rate. What is the likely diagnosis?

yes

13%

8%

13%

53%

111748

0.056

4c7587859b88d97a6161fe82436876e9

[ "A: Infectious perichondritis", "B: Rheumatoid arthritis", "C: Granulomatosis with polyangiitis", "D: Polyarteritis nodosa", "E: Relapsing polychondritis" ]

E: Relapsing polychondritis

67

apr-27-2006

A 39-year-old Zambian man who has tested positive for the human immunodeficiency virus presented with a three-week history of a draining neck mass. What is the most likely diagnosis?

yes

16%

41%

21%

12%

10%

85230.

0.088

c95060794df4aaea2f4877fb9164bd0a

[ "A: Actinomycosis", "B: Scrofula", "C: Kaposi sarcoma", "D: Burkitt lymphoma", "E: Nocardiosis" ]

B: Scrofula

68

apr-27-2017

A 25-year-old man presented to the emergency department with severe neck pain after a high-speed motor vehicle collision resulted in neck hyperextension. Axial CT scan of the C2 vertebrae is shown here. What is the diagnosis?

yes

48%

8%

12%

6%

25%

79770

0.071

03742f094dc0d7087d0045a6dab0fcf0

[ "A: Traumatic spondylolisthesis of the axis (hangman’s fracture)", "B: Odontoid fracture (dens fracture)", "C: Cervical spinous process fracture (Clay-shoveler fracture)", "D: Flexion tear drop fracture", "E: Cervical burst fracture (Jefferson fracture)" ]

A: Traumatic spondylolisthesis of the axis (hangman’s fracture)

69

apr-27-2023

A 75-year-old woman presented to the infectious diseases clinic with a 10-day history of painful lesions on the right hand and forearm. An aspiration of the hand lesion was performed. Bacterial culture of the aspirate grew filamentous, gram-positive, acid-fast branching rods. Which of the following activities likely preceded development of the lesions?

yes

21%

45%

10%

13%

11%

62473

0.077

e0250197ce2ec979f8e3237f2d11b526

[ "A: Cleaning a fish tank", "B: Gardening", "C: Getting bitten by a sandfly", "D: Handling feline waste", "E: Petting an armadillo" ]

B: Gardening

70

apr-28-2011

What is the diagnosis?

no

2%

7%

11%

73%

7%

92860

0.019

0579fd32596b4bfadefcc199a4b810bb

[ "A: Addison's disease", "B: Alkaptonuria", "C: Hematoma", "D: Melanoma", "E: Zidovudine exposure" ]

D: Melanoma

71

apr-28-2016

What is the most likely diagnosis in this man with left knee swelling and these findings for the past 2 years?

yes

14%

7%

14%

15%

51%

89991

0.061

98979040596bbb4669210d6bc01ad3c8

[ "A: Nonpulmonary tuberculosis", "B: Tularemia", "C: Cutaneous anthrax", "D: Sporotrichosis", "E: Actinomycosis" ]

E: Actinomycosis

72

apr-28-2022

A 53-year-old landscaper presented to the dermatology clinic with a 4-month history of red, raised, itchy skin lesions on his left lower back and buttock. Physical examination showed numerous verrucous nodules and plaques with overlying crusting and surrounding erythema on the left lower back and buttock. Grocott-Gomori methenamine silver staining showed broad-based budding organisms. Chest imaging showed no abnormalities. Which of the following is the best treatment?

yes

10%

57%

6%

15%

12%

48300

0.047

73b6c0908dac03ec8d3be2a6a420eef0

[ "A: Clarithromycin and amikacin", "B: Itraconazole", "C: Penicillin", "D: Rifampicin, isoniazid, pyrazinamide, and ethambutol", "E: Trimethoprim-sulfamethoxazole" ]

B: Itraconazole

73

apr-29-2010

What is the diagnosis?

no

5%

42%

5%

9%

39%

98161

0.1

0910c518725f9c555bcca2bddfe6f347

[ "A: Cerebral aneurysm", "B: Chiari I malformation", "C: Neurofibromatosis", "D: Paget disease", "E: Subdural hematoma" ]

B: Chiari I malformation

74

apr-29-2021

A 54-year-old man presented to the emergency department with confusion and vomiting. He also reported an unintentional 10 kg weight loss and progressive darkening of his skin over the past 6 months. Laboratory studies showed a serum glucose of 40 mg per deciliter (reference range, 70 to 110 mg per deciliter), sodium of 108 mmol per liter (reference range, 136 to 145), and a potassium of 6.4 mmol per liter (reference range, 3.5 to 5.1). What is the diagnosis?

yes

85%

4%

6%

3%

2%

34900

0.006

1f97d4f64141f6dc84f04f8ebd612687

[ "A: Primary adrenal insufficiency (Addison’s disease)", "B: Acanthosis nigricans", "C: Cushing’s disease", "D: Smoker’s melanosis", "E: Solar lentigines" ]

A: Primary adrenal insufficiency (Addison’s disease)

75

apr-30-2009

What is the diagnosis?

no

7%

8%

61%

10%

14%

103331

0.039

dce920232c50772aff2df98d1750a5ef

[ "A: Coxsackievirus infection", "B: Gorlin's syndrome", "C: Herpes zoster", "D: Orbital cellulitis", "E: Superficial pyoderma" ]

C: Herpes zoster

76

apr-30-2015

What is the most likely diagnosis?

no

7%

10%

14%

60%

10%

112843

0.041

fd9ada662d2af3067a360cbd6a5fc90e

[ "A: Staphyloma", "B: Pigmentary glaucoma", "C: Conjunctival hemorrhage", "D: Melanoma", "E: Squamous-cell carcinoma" ]

D: Melanoma

77

apr-30-2020

A 34-year-old man with a history of intravenous drug use and hepatitis C infection presented to the ophthalmology clinic with a 1-week history of pain and decreased vision in his right eye. The visual acuity was 20/400 in the right eye and 20/20 in the left eye. Slit-lamp examination of the right eye showed conjunctival injection and inflammation in the anterior chamber. Indirect ophthalmoscopy showed vitreous haze with yellow-white lesions on the retina and optic nerve. Following workup, surgery was performed and a white mass measuring 4 mm by 3 mm by 1 mm was seen adherent to the optic nerve. What is the most likely diagnosis/etiology?

yes

9%

10%

9%

61%

10%

40913

0.038

6ca6681c2cea5af4a548e47c267d8779

[ "A: Retinoblastoma", "B: Amelanotic uveal melanoma", "C: Astrocytic hamartoma", "D: Fungal endophthalmitis", "E: Malignant optic nerve prolapse" ]

D: Fungal endophthalmitis

78

aug-01-2013

What is the most likely diagnosis?

no

21%

19%

7%

30%

24%

109644

0.151

9ba88908b3390da7aeecfb9b6215c84c

[ "A: Discoid lupus", "B: Erythema migrans", "C: Psoriasis", "D: Tinea corporis", "E: Urticaria" ]

E: Urticaria

79

aug-01-2019

A 56-year-old woman presented to the emergency department with a 1-month history of abdominal pain in the left upper quadrant. Her medical history was notable for polysubstance use disorder, hepatitis C virus infection, and rheumatoid arthritis managed with naproxen. Computed tomography of the abdomen was performed. What is the most likely diagnosis?

yes

18%

9%

28%

35%

10%

85024

0.11

b1cab883e9444eb6b9a2cc61c9f8d00e

[ "A: Avascular necrosis of the spleen", "B: Visceral leishmaniasis", "C: Emphysematous infection of the spleen", "D: Gastrospenic fistulization", "E: Bezoar" ]

D: Gastrospenic fistulization

80

aug-02-2012

What is the diagnosis?

no

10%

19%

30%

25%

15%

165,436

0.144

b1781d720be0a3a00a0e0c7b3119cb70

[ "A: Congenital hypothyroidism", "B: Congenital syphilis", "C: Dentinogenesis imperfecta", "D: Neonatal hyperbilirubinemia", "E: Williams syndrome" ]

D: Neonatal hyperbilirubinemia

81

aug-02-2018

A 69-year-old man presented to the dermatology clinic with a 2-month history of a pruritic rash. The rash first appeared on his right wrist and within 2 weeks had spread to his arms, legs, and trunk. He had completed treatment for chronic hepatitis C virus (HCV) infection with a 12-week course of elbasvir and grazoprevir 3 months before the onset of the purple papular rash. Some lesions showed a fine reticulate pattern of dots and lines (Wickham's striae). What is the diagnosis?

yes

13%

16%

13%

47%

11%

96606

0.07

d5027dc84290c168a704d3583a5f4721

[ "A: Drug eruption", "B: Reactivation of endogenous latent varicella-zoster virus", "C: Discoid lupus erythematosus", "D: Lichen planus", "E: Pemphigus" ]

D: Lichen planus

82

aug-03-2006

What is the diagnosis?

no

30%

19%

31%

16%

4%

128251

0.126

5d6e74aaeca36cdc05903f3e2b8822fb

[ "A: Elephantiasis", "B: Hydrocele", "C: Inguinal hernia", "D: Non-seminomatous germ-cell tumor", "E: Testicular torsion" ]

C: Inguinal hernia

83

aug-03-2017

What is the most likely diagnosis for these two painless periumbilical masses in a 76-year-old man with type 2 diabetes mellitus?

yes

2%

9%

3%

80%

6%

67978

0.011

06d64a1ff70ad51f47ae5e6187c7f89e

[ "A: Abscess", "B: Dermatofibrosarcoma protuberans", "C: Hematoma", "D: Insulin-induced lipohypertrophy", "E: Nodular fasciitis" ]

D: Insulin-induced lipohypertrophy

84

aug-03-2023

A 95-year-old woman presented with a 4-week history of dyspnea and dry cough. She had not previously reported these symptoms to her doctor. For the past 6 months, she had been taking nitrofurantoin daily to prevent recurrent urinary tract infections. Her oxygen saturation was 83% on room air. Physical examination showed inspiratory crackles in the upper lung fields but no jugular venous distention or edema. Laboratory studies showed neutrophilic leukocytosis but no eosinophilia or elevations in aminotransferase levels. A sputum culture and viral respiratory panel were negative. Chest radiograph and computed tomography of the chest are shown. What is the most important element of the management of this condition?

yes

7%

69%

15%

4%

5%

23391

0.026

b7b9e26865a090a7c1ecb069e5c17ed8

[ "A: Antibiotics", "B: Cessation of nitrofurantoin", "C: Glucocorticoids", "D: Intravenous loop diuretics", "E: Scheduled nebulized bronchodilators" ]

B: Cessation of nitrofurantoin

85

aug-04-2011

This lesion developed on the chest of a 35-year-old man during treatment for a respiratory tract infection. What is the diagnosis?

yes

4%

10%

43%

34%

9%

105858

0.128

386a6c59e402c490027afc14a433b07c

[ "A: Acute urticaria", "B: Drug-induced pemphigus", "C: Erythema annulare", "D: Fixed drug eruption", "E: Stevens-Johnson syndrome" ]

D: Fixed drug eruption

86

aug-04-2016

A man presented with new peripheral edema. What diagnosis does his chest X-ray suggest?

yes

6%

8%

2%

32%

51%

106508

0.071

519991e9a255071495ba8ce81a9d7291

[ "A: Superior vena cava syndrome", "B: Dilated thoracic aorta", "C: Right middle lobe pneumonia", "D: Cardiac tamponade", "E: Giant right atrium" ]

E: Giant right atrium

87

aug-04-2022

A 71-year-old man presented with an 8-year history of enlarging nodules on his nose. On physical examination, he had painless, violaceous, indurated nodules on his nose, ears, fingers, and toes. Computed tomography of the chest revealed hilar and mediastinal lymphadenopathy. Skin biopsy showed non-caseating granulomas. What is the most likely diagnosis?

yes

15%

17%

36%

12%

20%

69090

0.103

ce2f2a1af407453448aee5c550096885

[ "A: Entomophthoramyocosis", "B: Leprosy", "C: Lupus pernio", "D: Lupus vulgaris", "E: Rhinophyma" ]

C: Lupus pernio

88

aug-05-2010

An 18-year-old woman presented with visual loss in the right eye. What diagnosis is suggested by this finding on ophthalmoscopy?

yes

5%

13%

17%

20%

45%

74241

0.078

8dbecc629f6cde0f86a99a83adb85a81

[ "A: Cystic fibrosis", "B: Marfan syndrome", "C: Sickle cell disease", "D: Tay-Sachs disease", "E: Von Hippel-Lindau disease" ]

E: Von Hippel-Lindau disease

89

aug-05-2021

A 62-year-old woman with recent travel to Colombia presented with pruritic, draining nodules with a central punctum on her back and buttocks. The lesions were unchanged after a trial of antibiotics. What is the most likely diagnosis?

yes

23%

10%

14%

36%

17%

110076

0.104

8251c1020681d077eefb61aadb0c070a

[ "A: Cutaneous leishmaniasis", "B: Epidermoid cyst", "C: Furunculosis", "D: Myiasis", "E: Tungiasis" ]

D: Myiasis

90

aug-06-2009

This 6-week old presented with scrotal pain. What is the diagnosis?

yes

8%

17%

30%

4%

41%

123854

0.095

10d4872b0acd0d53709eb9ad210918b3

[ "A: Bilateral cryptorchidism", "B: Bilateral inguinal hernias", "C: Isolated right hydrocele", "D: Left retractile testis", "E: Left testicular torsion" ]

E: Left testicular torsion

91

aug-06-2015

Which of the following is the least likely differential diagnosis associated with this image finding?

no

51%

13%

10%

14%

11%

89280

0.06

8cf8c3bfa9c1346b7bb9a42fb246f981

[ "A: Pulmonary hypertension", "B: Neoplasm", "C: Vasculitis", "D: Septic emboli", "E: Infection" ]

A: Pulmonary hypertension

92

aug-06-2020

A 60-year-old woman presented to an oral surgery clinic with gum swelling. She had associated bleeding while brushing her teeth. She had a history of colorectal cancer treated with surgery and chemotherapy. On examination, a large, nontender, pedunculated mass was noted. What is the diagnosis?

yes

11%

42%

21%

16%

10%

88448

0.086

e29c45036b05a659416c13466f811b3d

[ "A: Zimmerman-Laband syndrome", "B: Metastasis of colorectal cancer", "C: Gingival hyperplasia secondary to chemotherapy", "D: Alveolar soft part sarcoma", "E: Irritation fibroma" ]

B: Metastasis of colorectal cancer

93

aug-07-2008

This 35-year-old pet shop worker developed progressively spreading nodular lesions. He was afebrile. What is the most likely causative organism?

yes

7%

15%

39%

21%

17%

144757

0.094

c4763c4e290bf803f392a12c3a1ac5ce

[ "A: Acinetobacter baumannii", "B: Erysipelothrix rhusiopathiae", "C: Mycobacterium marinum", "D: Pasteurella multocida", "E: Staphylococcus epidermidis" ]

C: Mycobacterium marinum

94

aug-07-2014

What is the most likely diagnosis?

no

7%

14%

12%

13%

55%

93309

0.052

eb8b5c72ce584582b95a2708b1e96574

[ "A: Mucocele", "B: Necrotizing sialometaplasia", "C: Periapical abscess", "D: Periodontal abscess", "E: Syphilitic gumma" ]

E: Syphilitic gumma

95

aug-08-2013

What is the diagnosis in this 42-year-old man with bone pain?

yes

11%

28%

19%

34%

8%

84108

0.138

d26b5f419f68d0aee357d36945b33422

[ "A: Hypervitaminosis A", "B: Gaucher's disease", "C: Multiple myeloma", "D: Osteopetrosis", "E: Thalassemia minor" ]

B: Gaucher's disease

96

aug-08-2019

A 79-year-old man with a history of ischemic cardiomyopathy and chronic kidney disease presented 1 month after a transcatheter aortic-valve replacement (TAVR) with a serum creatinine level of 4.0 mg per deciliter (350 umol per liter), up from a baseline of 1.6 mg per deciliter (140 umol per liter). Renal biopsy is shown. What is the most likely diagnosis?

yes

10%

17%

13%

49%

12%

55114

0.066

077347bc16e778f4ad03f232cf8a8957

[ "A: Calcium oxalate deposition", "B: Ischemic acute tubular necrosis", "C: Renal artery infarction", "D: Cholesterol crystal embolization", "E: Cryoglobulinemic vasculitis" ]

D: Cholesterol crystal embolization

97

aug-09-2007

What is the diagnosis?

no

15%

55%

5%

10%

14%

137802

0.051

6e1b161166db53e9133c7d08c96cdeab

[ "A: Molluscum contagiosum", "B: Pearly penile papules", "C: Secondary syphilis", "D: Obstruction of smegma-producing gland", "E: Condyloma acuminatum" ]

B: Pearly penile papules

98

aug-09-2012

What diagnosis is suggested by the results of this coronary angiogram?

yes

3%

15%

7%

48%

27%

82891

0.074

f40315d5f4367e76481a8f636ddd887f

[ "A: Diabetes mellitus", "B: Fibromuscular dysplasia", "C: Marfan syndrome", "D: Polyarteritis nodosa", "E: Takayasu arteritis" ]

D: Polyarteritis nodosa

99

aug-09-2018

A 39-year-old man presented to the emergency department with anorexia, nausea, vomiting, oliguria, and diffuse deposits on his skin. The physical exam findings are associated with what underlying disease?

yes

59%

10%

14%

9%

8%

69493

0.042

021172e7aadf571a66f39d897e9e2444

[ "A: End-stage renal disease", "B: Acute myeloid leukemia", "C: Sarcoidosis", "D: End-stage liver disease", "E: Tuberculosis" ]

A: End-stage renal disease

100

aug-10-2006

A 25-year-old bodybuilder presented with a tender, erythematous mass in the left upper arm. What is the most likely diagnosis?

yes

30%

40%

20%

5%

90070

0.099

4e38bd8e44f0dcdde34efe8592d16dad

[ "A: Ruptured biceps tendon", "B: Abscess", "C: Axillary vein thrombosis", "D: Glenohumeral joint dislocation", "E: Osteosarcoma" ]

B: Abscess