Bloody diarrhea and kidney failure - 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 07-23-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,039
Threads: 189
Thanked 561 Times in 319 Posts
Reputation: 571
Kidney Bloody diarrhea and kidney failure

A 3-year old boy is hospitalized because of bloody diarrhea and dehydration. According to his mother, during the family outing to a Water Park, he swallowed contaminated water in the kiddie pool. By next day, he develops abdominal cramps, vomiting and bloody diarrhea, followed by kidney failure. His peripheral blood smear is shown. His stool culture grows an enteric pathogen that ferments lactose but not sorbitol and is indole positive. Which of the following may have contributed most to the boy’s renal failure?

a) An adenosine diphosphate (ADP)-ribosylating toxin
b) A superantigen
c) Diffuse intravascular coagulopathy (DIC)
d) Escherichia coli 0157:H7 septicemia
e) Shiga toxin
Attached Thumbnails
Bloody diarrhea and kidney failure-question3.jpg  
Reply With Quote Quick reply to this message
The above post was thanked by:
varash (07-23-2012)



  #2  
Old 07-23-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 457
Threads: 62
Thanked 274 Times in 186 Posts
Reputation: 284
Default

D.???i hope i am right
Reply With Quote Quick reply to this message
  #3  
Old 07-23-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by Casandra View Post
A 3-year old boy is hospitalized because of bloody diarrhea and dehydration. According to his mother, during the family outing to a Water Park, he swallowed contaminated water in the kiddie pool. By next day, he develops abdominal cramps, vomiting and bloody diarrhea, followed by kidney failure. His peripheral blood smear is shown. His stool culture grows an enteric pathogen that ferments lactose but not sorbitol and is indole positive. Which of the following may have contributed most to the boy’s renal failure?

a) An adenosine diphosphate (ADP)-ribosylating toxin
b) A superantigen
c) Diffuse intravascular coagulopathy (DIC)
d) Escherichia coli 0157:H7 septicemia
e) Shiga toxin

D is the answer
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
 
  #4  
Old 07-23-2012
tootsie's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 433
Threads: 16
Thanked 284 Times in 199 Posts
Reputation: 294
Default

D. The Kidney failure is due to Hemolytic Uremic Syndrome and those in the pic are schistocytes aka "helmet cells".
Reply With Quote Quick reply to this message
The above post was thanked by:
DrSK (07-23-2012)
  #5  
Old 07-23-2012
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 10
Threads: 2
Thanked 1 Time in 1 Post
Reputation: 11
Default

D. E.coli causing TTP-HUS.
Reply With Quote Quick reply to this message
  #6  
Old 07-23-2012
Master shifu's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 191
Threads: 14
Thanked 87 Times in 59 Posts
Reputation: 97
Default

Quote:
Originally Posted by Casandra View Post
A 3-year old boy is hospitalized because of bloody diarrhea and dehydration. According to his mother, during the family outing to a Water Park, he swallowed contaminated water in the kiddie pool. By next day, he develops abdominal cramps, vomiting and bloody diarrhea, followed by kidney failure. His peripheral blood smear is shown. His stool culture grows an enteric pathogen that ferments lactose but not sorbitol and is indole positive. Which of the following may have contributed most to the boy’s renal failure?

a) An adenosine diphosphate (ADP)-ribosylating toxin
b) A superantigen
c) Diffuse intravascular coagulopathy (DIC)
d) Escherichia coli 0157:H7 septicemia
e) Shiga toxin
HUS leading to schistocytes in PBF,haemorrhagic colitis leading to bloody diarrhoeae,Renal failure>>>Triad of E.coli 0157:H7 strain septicemia
Reply With Quote Quick reply to this message
  #7  
Old 07-28-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,039
Threads: 189
Thanked 561 Times in 319 Posts
Reputation: 571
Correct Answer correct answer :)

I think you all will be surprised (I know I was to know that the answer is E) Shiga toxin -> E.coli

I really liked that question - it's a good 'wake up' call

Why not D)Escherichia coli 0157:H7 septicemia?
E. coli
0157:H7 is not an invasive organism and thus will not enter the bloodstream to cause septicemia.

The patient has developed hemolytic-uremic syndrome (HUS), which is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The syndrome is most likely related to infectious diarrhea caused by enterohemorrhagic Escherichia coli 0157:H7. The patient’s peripheral blood smear shows microangiopathic blood smear, with marked red cell fragmentation, evidenced by "helmet cells", micro-spherocytes and thrombocytopenia.
Reply With Quote Quick reply to this message
The above post was thanked by:
anomali (07-28-2012), mayankkaushal (05-18-2013), tootsie (07-28-2012)
  #8  
Old 07-28-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 104 Times in 62 Posts
Reputation: 114
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by Casandra View Post
I think you all will be surprised (I know I was to know that the answer is E) Shiga toxin -> E.coli

I really liked that question - it's a good 'wake up' call

Why not D)Escherichia coli 0157:H7 septicemia?
E. coli
0157:H7 is not an invasive organism and thus will not enter the bloodstream to cause septicemia.

The patient has developed hemolytic-uremic syndrome (HUS), which is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The syndrome is most likely related to infectious diarrhea caused by enterohemorrhagic Escherichia coli 0157:H7. The patient’s peripheral blood smear shows microangiopathic blood smear, with marked red cell fragmentation, evidenced by "helmet cells", micro-spherocytes and thrombocytopenia.
Ferments Lactose but not sorbitol and is indole positive: They said, should u explain us that?
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
  #9  
Old 07-28-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,039
Threads: 189
Thanked 561 Times in 319 Posts
Reputation: 571
Default

Quote:
Originally Posted by alfjof View Post
Ferments Lactose but not sorbitol and is indole positive: They said, should u explain us that?
What is here to explain? It's typical E.coli 0157:H7

E. coli O157:H7 is incapable of utilizing sorbitol (sorbitol-negative), and therefore, produces colorless colonies on sorbitol agar, whereas, other E. coli bacteria are sorbitol-positive and appear pink on the sorbitol plate.

Re-read the explanation I posted before and if you still have some doubts get back to me
Reply With Quote Quick reply to this message



Reply

Tags
Blood-Films, Microbiology-, Pathology-, Renal-, 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
Bloody diarrhea After Hamburger! menatallah Elgohary USMLE Step 1 Forum 10 09-19-2011 05:06 PM
Swollen Knee Joint + H/O Bloody Diarrhea Ace3 USMLE Step 2 CK Forum 9 07-20-2011 01:16 AM
Management of non-bloody diarrhea in setting of recent antibiotics USMLE-Syndrome USMLE Step 2 CK Forum 12 06-25-2011 02:58 PM
Bloody Diarrhea and the use of Antibiotics! docoftheworld USMLE Step 2 CK Forum 3 01-22-2011 09:10 AM
Intermittant Bloody Diarrhea Seetal USMLE Step 1 Forum 4 04-29-2010 02:50 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)