•A 62-year-old man with chronic obstructive pulmonary disease presented to the emergency department with a 2-day history of dyspnea. He required intubation and ventilation when he was found to be in hypercapnic respiratory failure. Five days after admission to the ICU, his urine became green. Which of the following medications caused this?

•An 83-year-old man presented with food impaction after eating pork. He reported intermittent difficulty with swallowing ongoing for several months. An esophagogastroduodenoscopy was performed to relieve the obstruction. During the endoscopy, the duodenal mucosa was as shown. What is the diagnosis?

•A 73-year-old woman with rheumatoid arthritis presented with a 1-month history of pain in her right eye. She had stopped immunosuppressive treatment a few years earlier. There was no recent history of trauma. Slit-lamp examination showed hyperemia, inflammation, and marked scleral thinning with exposure of the underlying choroid. What is the most likely diagnosis?

•A 62-year-old man presented to the emergency department with a 2-week history of generalized weakness and a diffuse rash. On examination he had a temperature of 38.1°C Physical examination showed a maculopapular, hyperpigmented, and scaly eruption on his palms, soles, and trunk. Which one of the following is the diagnosis?

•A 59-year-old man with metastatic colon cancer presented to the dermatology clinic with a 10-week history of painless and nonpruritic skin lesions coalescing around a large abdominal scar from a hemicolectomy performed 3 years earlier. On examination, the lesions were firm, pink to violaceous in color, and vesicular-appearing. What is the diagnosis?

•A 72-year-old woman with a history of esophageal strictures presented to the emergency department with a 3-month history of a rash on both legs. What is the most likely diagnosis?

•An 81-year-old man with a history of atrial fibrillation and hypertension presented to the emergency department after a fall. His medications were apixaban, ramipril, bisoprolol, amlodipine, and amiodarone. Physical examination showed discoloration of his nose, cheeks, and forehead. What is the most likely diagnosis?

•A 19-year-old man presented to the dermatology clinic with a 3-month history of an enlarging ulcer on his right hand and multiple tender subcutaneous nodules on the right forearm and elbow. Five months earlier, he had traveled to Ecuador, and worked on an organic produce farm. On physical examination, the ulcer measured 3 cm in diameter and was tender with a firm border. What is the most likely diagnosis?

•A 57-year-old man with stage 3b colon cancer on adjuvant chemotherapy noticed progressive darkening of his palms that was not associated with redness, scaling, or pain. The plantar aspects of his feet were minimally affected but the remainder of his skin was normal. What is the diagnosis?

A 70-year-old woman presented with a 1-week history of dizziness and generalized rash following the onset of a viral respiratory tract infection. On physical examination, she had a generalized, macular, nonblanching, purplish rash. What is the most likely diagnosis?

A 37-year-old man presented with a 4-year history of excessive sweating, headaches, and joint pain. His wife had also noticed increasing skin folds on his scalp. What is the most likely diagnosis?

A 42-year-old man who was undergoing treatment for non-Hodgkin’s lymphoma presented to the oncology clinic with changes in his fingernails. Five months earlier, he had presented with gastric-outlet obstruction and had received a diagnosis of high-grade B-cell non-Hodgkin’s lymphoma. What is the most likely underlying cause of this presentation?

A 71-year-old man with cirrhosis presented to the ED with severe diffuse pruritus 3 months after being treated with oral and topical glucocorticoids for an erythematous, scaly rash. Physical exam revealed this rash on the patient’s neck, hands, and genital area. What is the most likely diagnosis?

A 65-year-old man presented with a recent history of weight loss, early satiety, mild flank pain, and this rash on his legs. CT scan revealed a mass in the head of the pancreas. Which neuroendocrine tumor is associated with this characteristic rash?

A man presented with difficulty walking and urinary incontinence. On examination, his pupils were nonreactive to bright light but constricted when focusing on a near object. What is the diagnosis?

A 64-year-old man presented with a two-year history of this asymptomatic skin condition, which was symmetrically distributed over his trunk, arms and legs. Laboratory tests demonstrated a raised fasting blood glucose level. What is the most likely diagnosis?

What is the diagnosis?

This 12-year-old boy presented with abdominal pain. What is the diagnosis?

what serum level is expected to be high in this patient?