This quiz is just for fun. Test your diagnostic skills with the dermatological photos, then separate truth from fiction in the statements about myasthenia gravis and dizziness. Any of these statements below might be true… and any might be pulling your leg. Answers are below.
1. Lumps, bumps and lesions. Match these photos to the following conditions:
b) Incisional hernia
c) Ganglion cyst
f) Popliteal cyst (Baker’s cyst)
g) Pyogenic granuloma
h) Sebaceous cyst
3. Myasthenia gravis: (true or false)
a) affects both men and women, but tends to strike women younger
b) is associated with an abnormal thyroid gland
c) can be inherited by neonates from their mothers
d) the commonest first symptom is ptosis (drooping eyelid)
e) is typically associated with reduced life expectancy
4. Dizziness: (true or false)
a) is likely to have a central cause (i.e. TIA, stroke) if accompanied by ataxia or diplopia
b) is likely to have a peripheral cause (i.e. inner ear) if accompanied by tinnitus or hearing impairment
c) is likely to have a peripheral cause if accompanied by vertical nystagmus
d) if due to benign positional vertigo, can often be cured outright in the office by a simple head-turning manoeuvre (the Epley manoeuvre)
e) patients should try to remain upright or nearly so for 24 hours after a successful Epley manoeuvre
1. 1. Ganglion cyst; 2. Chondrodermatitis; 3. Incisional hernia; 4. Keloids; 5. Sebaceous cyst; 6. Xanthelasma; 7. Pyogenic granuloma; 8. Parotitis; 9. Popliteal (or Baker’s) cyst.
2. Goitre. This carving comes from the diocese of Maurienne, in the high valleys of the Dauphiné. Well into the 19th century, this area and the surrounding mountain valleys were associated with endemic goitre and “cretinism,” attributed to mineral salts in the mountain streams. Goitre afflicted nearly 10% of the inhabitants of Maurienne in 1850, before the problem was solved by digging wells.
3. a) True; b) False. It’s associated with an abnormal thymus gland; c) False. The disease is neither heritable nor infectious, but neonates are sometimes born with some maternal antibodies that typically cause symptoms for 2-3 months; d) True, either unilateral or bilateral; e) False, the vast majority of treated patients can lead fairly normal lives with normal life expectancy.
4. a) True; b) True; c) False, vertical nystagmus signals a central lesion, rotatory nystagmus often (but not always) a peripheral problem; d) True; e) False, this was formerly recommended but has been found to be unnecessary.
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