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162397 Medicine

A 68-year-old man complains of several blisters arising over the back and trunk for the preceding 2 weeks. He takes no medications and has not noted systemic symptoms such as fever, sore throat, weight loss, or fatigue. The general physical examination is normal. The oral mucosa and the lips are normal. Several 2- to 3-cm bullae are present over the trunk and back. A few excoriations where the blisters have ruptured are present. The remainder of the skin is normal, without erythema or scale. What is the best diagnostic approach at this time?

ACulture of vesicular fluid for herpes viruses
BTrial of corticosteroids
CBiopsy of the edge of a bulla with some surrounding intact skin
DCT scan of the chest and abdomen looking for occult malignancy
Medicine
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162401 Medicine

36 year old Seema Rani gives a history of corrosive poisoning 3 months back. She has been suffering from severe dysphagia since then and it is more for solids than liquids. Endoscopic evaluation revealed a complex stricture involving the mid esophagus. Endoscopist tried dilatation of the stricture and post dilatation patient was complaining of severe chest pain and swelling of the neck. Resident doctor examined her and found surgical emphysema of the neck. She was kept nil per mouth and chest X-ray was taken. What would be the expected findings in that X-ray?

ALeft sided pleural effusion and Pneumomediastinum
BRight sided pleural effusion with pneumomediastinum
CBilateral pleural effusion with left sided pneumothorax
DCollapse of right lung and pericardial effusion
Medicine
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