Case Report

59 to male presenting with four week history of pharyngitis. Initially presented to local ED, where he was prescribed amoxicillin and Prednisone, after which symptoms improved, but returned soon after regimen completed.

Physical exam showed him to be in NAD, temp of 99 F, mild bilateral anterior cervical lymphadenopathy, and the above mass, which was nontender and hard to palpation.

Reports quitting smoking 20 years ago, denies any history of chewing tobacco. HIV, CT pending, but presentation makes me suspect neoplasm with oral candidiasis from recent Prednisone and abx.

Additional Cases

18y M with 2 week hx of discoloration and burning sensation on his tongue.

Hx of smoking, recently started on glycopyrrolate for hyperhidrosis. Thoughts?

59 yo M presents with 1 week history of painful mouth lesions.

States lesions came on gradually without precipitating cause. There is an absence of lesions on the mucus membranes, pharynx, and palates. Students, what do you think?

Sorry for poor quality.

4x4 mm lesion found on lateral tongue of 48 yof. Hx of alcohol abuse and 15 pack year history, although now smokes 5 cigarettes/month. What would your plan of action/Dx be?

34 year old pt. came in presenting shortness of breath.

Tumor found in lower portion of lung.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck.

Associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.

She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days.

Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse.

No chest pain, no previous cardiac history, no history of sudden death in family. Are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?