An elderly male patient presents with Hemorrhagic signs (petechiae), Hyperkeratosis of the hair follicles, Hypochondriasis, and Hematologic abnormalities. These "four Hs" are characteristic of deficiency of which of the following vitamins?

[Audio] An elderly male patient presents with Hemorrhagic signs ( petechiae), Hyperkeratosis of the hair follicles, Hypochondriasis, and Hematologic abnormalities. These "four Hs" are characteristic of deficiency of which of the following vitamins? Vitamin C This is a case of scurvy ( Vitamin C deficiency). The " four Hs" are characteristic of scurvy: hemorrhagic signs, hyperkeratosis of the hair follicles, hypochondriasis, and hematologic abnormalities. Perifollicular petechiae are the characteristic cutaneous finding. Among the Vitamin B deficiencies, we discussed pellagra, and it presents as a brown discoloration of the skin, especially in sun-exposed areas. Vitamin D deficiency may present with hair loss. And Vitamin K deficiency presents as bleeding/hemorrhage. None of these other Vitamin deficiencies present with hyperkeratosis of the hair follicles..

[Audio] A 19-year-old male presents with hyperpigmented patches and plaques on sun exposed areas, diarrhea, and behavioral changes. What is the MOST LIKELY diagnosis? Pellagra This is a case of pellagra, characterized by the 3Ds: diarrhea, dementia, dermatitis. All the other options are not associated with diarrhea and dementia..

[Audio] An adult, male presents with hypertrichosis, truncal acne, and purplish, atrophic striae all over the abdomen, buttocks, upper arms, and thighs. He is also noted to have central obesity. What is the MOST LIKELY diagnosis? Cushing's syndrome This is a case of Cushing's syndrome. None of the other choices would present with hypertrichosis, acne, and striae..

[Audio] A 45-year-old male presents with bilateral, localized, nonpitting nodules and plaques on bilateral shins. She was previously diagnosed to have Grave's disease. Which of the following is the MOST likely diagnosis? Pretibial myxedema are asymptomatic, red nodules that are usually present on the shins, ankles, or dorsum of the foot of patients with Graves' disease. Necrobiosis lipoidica are shiny, atrophic, red or yellow plaques with marked telangiectasia over their surface seen among patients with diabetes mellitus. Rheumatic nodules are painless nodules on the skin overlying bony prominences seen in patients with rheumatic fever. Tuberous xanthomas are firm, painless, red-yellow nodules that can coalesce to form multilobated tumors seen among patients with hyperlipidemias..

[Audio] A 13-year-old female presents with multiple lentigines around the nose and mouth, on the lips, and within the oral cavity. Multiple benign polyps of the small and large intestines were also present. Which of the following is the mode of inheritance of this condition? This is a case of Peutz-Jeghers syndrome, which is autosomal dominant, due to mutations in a novel serine threonine kinase gene..

[Audio] A 45-year-old male presents with multiple, erythematous plaques topped with thick silvery scales on the trunk, extremities, and the scalp. He also complains of pain on bilateral wrist and ankle joints. Which of the following is the MOST LIKELY diagnosis? This is a case of psoriasis with psoriatic arthritis. All the other options do not present with erythematous plaques topped with thick, silvery scales, which is characteristic of psoriasis..

[Audio] An adult female presents with well-defined, depigmented patches on the face and bilateral dorsal hands. Which of the following disorders is most frequently associated with this condition? This is a case of vitiligo, and diseases of the thyroid gland are the most frequently associated disorders, occurring in up to 30% of patients with vitiligo..

[Audio] A 17-year-old male presents with numerous, palpable, non-blanching papules on bilateral legs, thighs, and buttocks. A few days before the appearance of the lesions, patient was noted to have fever, cough, and sore throat. Which of the following is the MOST LIKELY diagnosis? This is a case of HSP, which followed an upper respiratory tract infection. All the other options do not present with non-blanching erythematous lesions on the lower Extremity. Rheumatic nodules – presents with nodules Pyoderma gangrenosum – presents with ulcer SLE – presents with erythematous, but blanching, papules and plaques.