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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.

January 2021

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    Bitot’s spots

    Bitot’s spots occur due to deficiency of which vitamin?
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    Sudden onset lower back pain

    An 86-year-old man presented with a fall associated with sudden severe lower back pain and bilateral leg weakness. Based on the findings, what is the most likely explanation?
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December 2020

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    Acute myeloid leukaemia

    Regarding patients newly diagnosed with acute myeloid leukaemia, which one of the following is incorrect?
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    Pain in the proximal right tibia

    A 13-year-old girl presented with a 2-week history of mild pain in the right knee. On examination, we found tenderness in the proximal right tibia with no swelling, ecchymosis, or any deformity. The range of motion of the knee was normal. What is the most likely diagnosis?
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    Fever, weight loss, and leg myalgia in a 59-year-old man

    A 59-year-old man presented with a 15-day history of fever, headache, leg myalgia, and weight loss. Physical examination showed no pathological findings. Initial diagnostic workup showed an increased concentration of C-reactive protein (16 mg/dL). An acute viral infection was suspected, and symptomatic treatment with oral analgesics and antipyretics was initiated, with clinical improvement noted 4 days after admission. However, fever and headache recurred 1 week after, and inflammatory marker concentrations were increased; a PET scan was done, which showed an increase in metabolic activity on the vascular walls of small and medium vessels. What is the likely diagnosis?
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    Lesions on liver found during laparoscopy

    A 31-year-old woman presented with fever, right-upper-quadrant abdominal pain, and hepatitis; ALT 629 units/L and AST 634 units/L. She had recently been sexually active with a new male partner. During laparoscopy we found numerous lesions on surface of liver. What is the likely diagnosis?
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November 2020

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    Intrauterine device, weight loss, pain, and malaise

    A 24-year-old woman presented with a three-month history of severe abdominal pain, 15.8 kg weight loss, night sweats and general deterioration. The uterus, with an IUD lodged in the myometrium, was enlarged by a mass invading the anterior abdominal wall, bladder, caecum, and small bowel. What is the most likely diagnosis?
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    A hard lump on the toe is a benign enchondroma

    Enchondromas are benign cartilage-forming tumours. What is the most common clinical feature of long bone enchondromas?
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October 2020

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    A baby with red plaques on the face

    A 3-month-old boy presented to our clinic with several well-defined erythematous and annular plaques with indurated borders located on the face appearing 3 weeks post-partum. Histological examination showed a vacuolar interface dermatitis with dermal oedema and periadnexal infiltrate of lymphocytes. What is the most likely diagnosis?
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    Auricular inflammation with kidney injury

    A 37-year-old woman presented with a 3-year history of episodic swelling and pain in her left ear. The current episode was accompanied by decreased urine volume, hypertension, oedema of both legs, 1+ proteinuria, and microscopic haematuria. Her creatinine increased from 0.9 mg/dL 1 year ago, to 4.2 mg/dL. What is the most likely diagnosis of her kidney disease?
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