Thanks for the reply. Changed auto-detect as suggested and it made no difference. Took a closer look at page 20 and the object in it is not an image but a video. That wasn't clear until I clicked on the image and a play bar appeared. It's size is H 6.67" and W 8.89". That fits on the slide. However maybe because the postscript custom had to be set to W 7.5" H 13.33" something somewhere thinks it won't fit and flips it so that it will.
There are all sorts of other paper sizes that can be selected for the PDF Creator printer, including "HDTV 1920 x 1080". However that is a tall vertical page in print preview in PPT 2010 no matter if the page is set to portrait, landscape, or rotated landscape (this is for all pages, not just the problem one.) Actually those settings don't stick, set it to whatever orientation and it always snaps back to landscape. For all the high ratio page sizes (anything more extreme than "legal") only the custom postscript printer could be made to actually go landscape in print preview and when written to the PDF, and that was by setting H and W backwards (H=13.33, W=7.5). Conversely, A4, Letter, and other common real paper sizes all have the expected orientations.
The short term solution here is probably to get 1 frame out of the video and replace the video with that image. Not sure how to do that for a video inside power point though.