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  #1  
Old 03-15-2012
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Question Star Wars lover with a finding on blood analysis.

45 old man, a video-game designer is coming to your office for evaluation. You see a bold pale man with a short stature. You notice moderate obesity with predominant abdominal fat distribution. He admits drinking 3-4 beers every day while programming new software for phone company. He tells you that he loves Star Wars and that he is a vegetarian since he was 38. Man complains about decreased libido and occasional blood in stool. On the evaluation he has internal hemorrhoids. His MCV is 114. What has contributed the most to this man's blood finding?

a. Sedentary life style.
b. B12 deficiency
c. Iron deficiency anemia
d. Diabetes.
e. Radiation exposure from the computer
f. Folic acid deficiency.
g. Decreased testosterone
h. Increased estrogene.
i. Social phobia
j. Middle age chrisis
k. Childhood trauma
l. Growth factor mutation
m. midi-chlorians
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Last edited by DocSikorski; 03-15-2012 at 08:54 PM.
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Old 03-15-2012
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B 12 .... ?
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Old 03-15-2012
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Childhood trauma? Eeek :/

I go with A lol
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Old 03-15-2012
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Default B) B12 Def.

Key information in this question -
  • He's a vegetarian since he was 38 years old
  • His current age is 45
  • MCV of 114 = Megaloblastic Anemia
  • Alcoholic = Drinks 3 to 4 beers a day

Basically, his B12 stores have been depleted since he turned vegetarian almost 7 years ago, his liver is prolly cirrhosed or has some sort of damage and if ANY B12 was remaining is probably depleted.

I'd go with B) B12 Deficiency.
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Old 03-15-2012
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Quote:
Originally Posted by Dr.NickRiviera View Post
Childhood trauma? Eeek :/

I go with A lol
I answered based on MCV - 114 / Normal range 80-100 /
He's a vegan already 7-8 years long so B12 in liver will be depleted ...

Let's wait for the correct answer
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Old 03-16-2012
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Quote:
Originally Posted by beka-CTS View Post
I answered based on MCV - 114 / Normal range 80-100 /
He's a vegan already 7-8 years long so B12 in liver will be depleted ...

Let's wait for the correct answer
Oh true, i didnt see the mcv.
Yea it should be b12 def then.
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Old 03-16-2012
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low cobalamine due to vegan?
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Old 03-16-2012
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Guys you rock!
Yes its b12

I am emphasizing the fact that drinking beer will not make you deficient in folic acid, which I didnt know.
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Old 03-16-2012
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why is there internal hemorrhoids?

If he is a vegan, shouldn't he have problem with defecation?
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Old 03-16-2012
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Quote:
Originally Posted by patho2012 View Post
why is there internal hemorrhoids?

If he is a vegan, shouldn't he have problem with defecation?
Sitting for too long can predispose to that.
Maybe he eats nuts only =)

================

the question is inspired by some of my colleagues.
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