Severe atherosclerosis and failure of bypass! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-13-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 963 Times in 394 Posts
Reputation: 973
Send a message via Yahoo to ricko335
Question Severe atherosclerosis and failure of bypass!

A 47-year-old nonsmoker is found to have severe atherosclerosis and single-vessel arterial runoff to both of his feet. An arterial bypass is performed but fails within 2 days of the operation. Which of the following would account for these findings?
  • A. Surreptitious warfarin intake
  • B. Phosphoglucomutase deficiency
  • C. Alpha-keto acid dehydrogenase complex deficiency
  • D. Methylenetetrahydrofolate reductase deficiency
  • E. Excessive production of high density lipoprotein
Reply With Quote Quick reply to this message
The above post was thanked by:
m82_ghasemi (09-16-2011), riya10 (09-15-2011), step1an (09-15-2011), usmle2011 (09-15-2011), USMLE2011m (11-29-2011)



  #2  
Old 09-13-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 512
Threads: 57
Thanked 319 Times in 163 Posts
Reputation: 329
Default

Warfarin is the culprit
it shud be used along with heparin.
Reply With Quote Quick reply to this message
  #3  
Old 09-13-2011
laurier's Avatar
USMLE Forums Addict
 
Steps History: CK Only
Posts: 105
Threads: 19
Thanked 69 Times in 32 Posts
Reputation: 79
Default

D. Methylenetetrahydrofolate reductase deficiency
Reply With Quote Quick reply to this message
 
  #4  
Old 09-15-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 512
Threads: 57
Thanked 319 Times in 163 Posts
Reputation: 329
Default

whats d answer??
Reply With Quote Quick reply to this message
  #5  
Old 09-16-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 963 Times in 394 Posts
Reputation: 973
Send a message via Yahoo to ricko335
Default

The correct answer is D.
This patient is very likely hypercoagulable.

MTHFR produces 5-methyl-THF (tetrahydrofolate), which is required to metabolize homocysteine to methionine. A deficiency in MTHFR is the most common cause of homocystinuria, which leads to hypercoagulability.

HDL is thought to protect the vascular system by scavenging excess cholesterol, which is a key substrate in atherosclerosis. Warfarin decreases coagulability. Phosphoglucomutase converts G1P to G6P for gluconeogenesis. Alpha-keto acid dehydrogenase complex metabolizes branched chain amino acids, the accumulation of which is not known to cause hypercoagulability.
Reply With Quote Quick reply to this message
The above post was thanked by:
agussmontes (09-16-2011), dinosaur108 (09-16-2011), SHICE (09-18-2011), usmle2011 (09-16-2011)



Reply

Tags
Cardiovascular-, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Sudden Severe Headache rasheed USMLE Step 1 Classic Clues 2 02-17-2013 11:37 PM
Aortic Coarctation Vs Subclavian atherosclerosis docoftheworld USMLE Step 2 CK Forum 5 06-08-2011 11:18 AM
Biostatistics #1 - triglyceride levels and degree of atherosclerosis bebix USMLE Step 1 Forum 8 06-02-2011 06:36 AM
cause of lacunar infarction?lipohyalinosis or carotid atherosclerosis struggle USMLE Step 1 Forum 1 05-30-2011 09:39 AM
1st step in pathogenesis of atherosclerosis caused by hyperlipidemia lemontea88 USMLE Step 1 Forum 3 01-01-2010 06:09 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)