1. Please consider the following:
A 53-year-old lady developed a subacute flaccid quadriparesis and bilateral facial weakness. A diagnosis was made and treatment initiated. Her strength began to improve, but a week later she developed sudden onset left sided weakness. The following investigations were carried out:
Urgent CT brain scan: normal, but poor quality scan
Na 132 mmol/L, K 4.4 mmol/L, urea 7.2 mmol/L, creatinine 110 mmol/L, albumin 38 mmol/L, Ca 2.3 mmol/L, PO4 2.1 mmol/L, Hb 11.5 g/dL, white cell count 8.4 × 109/l, platelets 35 × 109/L.
What is the underlying cause of her deterioration?
Paroxsymal nocturnal haemoglobinuria (PNH)
Thrombotic thrombocytopenic purpura (TTP)
Haemolytic uraemic syndrome (HUS)
Heparin induced thrombocytopenia (HIT)
2. Please study the following image:
This man presented with headache and obscurations of vision. What is the underlying diagnosis?
(Copyright: Diepgen TL, Yihune G et al. Dermatology Online
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