(BMJ)—A 7-yo girl presented w/ neck stiffness and trismus while being treated for a presumed throat infection. Exam: fixed torticollis w/ restricted neck movement; tonsillar erythema; lymphadenopathy of cervical nodes. CT confirmed dx. What is it?
Idiopathic spasmodic torticollis
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Grisel syndrome
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Retropharyngeal abscess
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Acute dystonic reaction
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Juvenile-onset Huntington disease
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(BMJ)—A 58-yo male presented w/ tongue pain and indentations plus a 6-mo hx of progressive dyspnea on exertion. PMHx: carpal tunnel release 2y prior. FHx: negative for cardiac infiltrative dz. Nonsmoker. Exam: scalloping at lateral edges of tongue; bilateral periorbital ecchymosis; mild bibasilar rales; pitting lower-extremity edema; jugular venous distention while sitting upright. ECG: low voltage. Echo: ventricular hypertrophy. What is the dx?
Hurler syndrome
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Sarcoidosis
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Fabry dz
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Tuberculosis
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Light-chain cardiac amyloidosis
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(BMJ)—A 15-yo female w/ hx of nephrotic syndrome treated w/ high-dose prednisolone presented w/ a 2-day hx of a painful rash around her mouth. She also had painful lesions in her mouth that prevented solid food intake. Exam: body temperature 38°C; lesions on lips and perioral skin; ulcers on buccal mucosa. What is the dx?
Hand-foot-and-mouth disease
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Stevens-Johnson syndrome
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Herpes simplex virus gingivostomatitis
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Behcet syndrome
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Bullous impetigo
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(BMJ)—A 9-yo boy presented w/ sudden-onset, painful swelling around the eyes. No trauma hx or meds. Exam: bilateral, periorbital, purplish red swelling; red tender lesions up to 4 cm in diameter on lower legs. Tests: throat swab/CXR both negative. Labs: elevated CRP. What is the dx?
Allergic reaction to insect bites
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Nodular vasculitis
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Idiopathic erythema nodosum
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Periorbital cellulitis
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Henoch-Schönlein purpura
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