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Old 03-21-2012
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Pediatrics Child with meconium ileus

A Guatemalan child with a history of meconium ileus is brought to a clinic because of a chronic cough. The mother notes a history of respiratory tract infections and bulky, foul-smelling stools. After assessment of the respiratory tract illness, the practitioner should also look for signs of

A) cystinuria
B) hypoglycemia
C) iron deficiency anemia
D) sphingomyelin accumulation
E) vitamin A deficiency
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Old 03-21-2012
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Ans ...E.............
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Old 03-21-2012
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CF?
pancreatic insufficiency leading to hypoglycemia?
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Old 03-21-2012
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Quote:
Originally Posted by kenlee View Post
CF?
pancreatic insufficiency leading to hypoglycemia?

Yes its pancreatic insufficiency leading to loss of fat and fat soluble vitamins like Vitamin A
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Old 03-22-2012
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Quote:
Originally Posted by kenlee View Post
CF?
pancreatic insufficiency leading to hypoglycemia?
That would actually coz hyperglycemia because with pancreatic insufficiency you have low levels of insulin. And as Hitman said, it would also lead to malabsorption of lipid soluble vitamins - A,D,E,K. I will post the correct answer soon.
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Old 03-22-2012
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I wish all the step 1 questions were like that....
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Ambition is a dream with a V8 engine. EP
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Old 03-22-2012
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The correct answer is E. The child likely has cystic fibrosis. In this disorder, an abnormality of chloride channels causes all exocrine secretions to be more viscous than normal. Pancreatic secretion of digestive enzymes is often severely impaired, with consequent steatorrhea and deficiency of fat-soluble vitamins, including vitamin A.

Cystinuria (choice A) is a relatively common disorder in which a defective transporter for dibasic amino acids (cystine, ornithine, lysine, arginine; COLA) leads to saturation of the urine with cystine, which is not very soluble in urine, and precipitates out to form stones.

Hypoglycemia (choice B) is not a prominent feature of children with cystic fibrosis who are on a normal diet. Hyperglycemia may occur late in the course of the disease.

Iron deficiency anemia (choice C) is not typically found in children with cystic fibrosis.

Sphingomyelin accumulation (choice D) is generally associated with deficiency of sphingomyelinase, as seen in Niemann-Pick disease.
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Old 03-22-2012
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Quote:
Originally Posted by DocSikorski View Post
I wish all the step 1 questions were like that....
Don't we all man, don't we all...
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Old 05-01-2012
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its E. whenever malabsorption always think of fat soluble vitamins.
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Old 05-01-2012
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Vitamin a def
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Old 05-01-2012
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Default Maddy

Why cant the person develop biliary cirrhosis in CF and develop hypoglycemia? Possible, right?
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