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Weird sensation, Hyporeflexia, and Abnormal Urine Test!

2K views 12 replies 6 participants last post by  Desos 
#1 ·
Made a question myself, there might be mistakes.
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A 55 year old lady, a host at the ballroom in downtown Chicago comes to you for annual evaluation. She proudly says that the events that she hosted for more than 20 years were reach in famous Midwestern steaks and expensive drinks. She appears skinny, jokes around and mentions many names of the city celebrities that she likes to have a drink or two with. She complains of feeling weird in her toes. You notice decreased Achilles tendon reflexes. After the blood analysis is done you make a diagnostic test and after the absence of radiolabeled substance in the urine you make a diagnosis. What is the reason of her condition?

a. Iron deficiency
b. Malaria
c. Hepatitis
d. CREST
e. Lupus
f. Pancreatitis
g. Goodpasture's syndrome
h. Myasthenia gravis
I. Ankylostoma
j. Beer consumption
 
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#7 ·
Nah, there are enough of clues and buzz words: She eats meat, but still the Shilling test is abnormal!

Neurosensory abnormality - tingling (weird feeling) and dicreased deep tendon reflexes. - classic B12 deficiency.

1. Pernicious anemia? - could be, but not in the options...
2. Bacterial overgrowth? - probably - not in options.
3. She could easily have had some previous bowel surgery - but not in options again...
4. the last one is left - pancreatitis? - might be... + she drinks.

so the answer is F Pancreatitis.

2hitman: very interesting poin - beer does not cause folic acid deficiency - there is a lot of folic acid in beer...

2Britney - it should have been difilobotrium latum
 
#8 ·
F = Pancreatitis

I agree with the clues for B12 deficiency

what is I say it's a Vit E deficiency.

alcoholism (Beer)--> Pancreatitis --> Pancreatic insufficiency--> deficiency in ADEK vitamines --(vit E def) causes neurodysfunction with posterior (Dorsal) colum demyelination and ... :rolleyes:

just stimulating our minds guys to think of a possible connection here that might not work !!!!

@ DocSikorski: I'm not very sure of your response to 2hitman's choice. Can you please give us a reference to clarify that!!
 
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