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Picture Quiz Gallery

The Lancet's interactive Picture Quiz Gallery hosts a new picture quiz each month. Play the picture quiz to test your medical knowledge and diagnostic skills. Each quiz is a multi-choice challenge which give you the option to play more or read about the patient's presentation and diagnosis.

August 2020

  1. Elsevier Ltd

    A wandering spleen, splenomegaly, and hypersplenism

    Regarding a wandering spleen one of the following statements is false. Which is it?
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    Categories: Clinical
  2. Elsevier Inc.

    Repeated exposure to tear gas

    A 27-year-old journalist presented to the emergency department with shortness of breath, cough, and globus sensation, which developed 2 weeks after the appearance of an itchy, skin rash. He had been repeatedly exposed to the tear gas over the previous 6 weeks. Which one of the following has been reported after repeated exposure to tear gas?
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    Categories: Clinical

July 2020

  1. Elsevier Ltd

    Global aphasia and headache

    A 26-year-old man patient presented with global aphasia and headache. Symptoms began 1 h before with visual problems on his right side. MRI—including diffusion-weighted imaging—showed no structural abnormalities but hypoperfusion in large areas of the left hemisphere. What is the most likely diagnosis?
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    Categories: Clinical
  2. Elsevier inc.

    Hepatocellular carcinoma in a transgender patient

    Which of the following has not been found to be associated with a higher risk of developing hepatocellular carcinoma?
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    Categories: Clinical
  3. Elsevier Ltd

    A rare cause of left-sided weakness in an elderly woman

    An 85-year old woman had sudden onset of left-sided weakness and slurred speech. In the preceding 6 months she had worsening intractable headaches. MRI head showed ring-enhancing lesions with oedema later found to be Balamuthia mandrillaris (figure). Which of following statements is false?
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    Categories: Clinical
  4. Elsevier inc.

    Coarctation of the aorta presenting for the first time in pregnancy

    A 24-week pregnant 18-year-old presented with acute respiratory distress and collapse. Her blood pressure was 222/78 mm Hg, pulse was 39 beats per minute, and she had weak radial pulses and absent pulses in her lower limbs. The following is or are treatment options for severe cases of coarctation of the aorta, select the best answer.
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    Categories: Clinical

June 2020

  1. Elsevier inc.

    Breast hypertrophy

    A 24-year-old woman developed sore, painful, bilateral, asymmetrical breast masses over a 3-month period. She had an etonogestrel—progestogen only—contraceptive implant put in 6 months earlier. She has no family history of cancer. The most likely diagnosis is which of the following?
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    Categories: Clinical
  2. Superficial thrombophlebitis and a fungating ulcer

    Superficial thrombophlebitis and a fungating ulcer

    A 26-year-old woman presented with history of recurrent superficial thrombophlebitis on all limbs, deep vein thrombosis involving the lower limbs, a fever, and a large non-healing ulcer on the left cubital fossa. There was no history of an oral or genital ulcer, eye involvement, or altered bowel habits. A whole body ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET showed ¹⁸F-FDG avid circumferential wall thickening of the aorta and its major branches. The most likely diagnosis is:
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    Categories: Clinical
  3. Elsevier Inc.

    Continuous positive airway pressure and a cardiac problem

    A 51-year-old patient receiving continuous positive airway pressure therapy (CPAP) for obstructive sleep apnoea syndrome develops reduced exercise tolerance and breathlessness on exertion. After CPAP augmentation he reports insomnia and morning fatigue. Which of the following best explains the cause of the patient's symptoms?
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    Categories: Clinical
  4. Elsevier Inc.

    Acute intermittent porphyria and MRI scan

    A 23-year-old Egyptian man with a 10-year history of hypertension and tachycardia, intractable epilepsy, psychiatric problems, and chronic abdominal pain, presented with status epilepticus and malignant hypertension. His MRI scan shows features of:
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    Categories: Clinical

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