Abdominal Migraine and Verruca Plana

October 26, 2012

Take this week's quiz and test your diagnostic and therapeutic skills.

Test your skills in this 5-question quiz, starting here.

QUESTION 1:

A 10-year-old boy presents with a chief complaint of "stomach pain," which he describes as dull and achy and is associated with nausea and usually vomiting. He denies diarrhea, belching, and sour brash. Between bouts, he has a normal appetite. Results of an extensive GI workup are normal. The family history is insignificant except that his mother reports that she has severe "menstrual headaches."

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QUESTION 2:

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QUESTION 3:

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This neonate was brought to the emergency department because of erythema and periumbilical swelling. He had been feeding well and sleeping through the night.

QUESTION 4:

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This boy was brought to the emergency department because of a rash, which had started on his face, abdomen, and legs and then spread to his back, buttocks, and hands. He had no sick contacts, had no significant medical history, and immunizations were up-to-date. He was afebrile and his vital signs were stable. The patches on the skin were slightly tender to palpation and felt warm to the touch.

QUESTION 5:

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An 11-month-old boy presented with mild fever and rhinorrhea of several day’s duration. His mother had noted "insect bites" on his left leg and left foot swelling. The pediatrician found a well-appearing, interactive child in no acute distress. Several erythematous round, flat-topped papules, less than 0.5 cm in diameter, were noted on the left leg and torso. Moderate, non-pitting edema was noted over his left foot. A pale dusky discoloration developed in the foot over the next several hours and edema spread proximally to involve most of the left lower leg. The next day, additional lesions were noted on the left leg and trunk and the eruptions had spread to the patient’s arms, ears, face, and genitalia.

ANSWER KEY:

Question 1. Answer: c

Question 2. Answer: b

Question 3. Answer: d

Question 4. Answer: a

Question 5. Answer: c