1. Image Challenge Q:
This patient presented with an S4 gallop, an elevated jugular venous pressure, and bilateral pitting edema. What diagnosis is most likely?
1. Congestive heart failure
2. Constrictive pericarditis
3. Subacute bacterial endocarditis
4. Systemic amyloidosis
5. Scleroderma

2. Image Challenge Q:
This patient presented with an S4 gallop, an elevated jugular venous pressure, and bilateral pitting edema. What diagnosis is most likely?
Answer:
Congestive heart failure
Congestive heart failure is one of the causes of acquired leukonychia totalis.