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Gyrus Daily Questions; Internal Medicine #70

2K views 7 replies 5 participants last post by  cingulate.gyrus 
#1 ·
A 58-year-old man comes to the clinic complaining of erectile dysfunction Over the past 6 months he has tried sildenafil and testosterone as well as a variety of herbal medications, but has had no success with these treatments Review of systems reveals complaints of some mild arthralgias and fatigue. which the patient has attributed to old age Examination reveals some mildly yellow-pigmented patches on the torso as well as a firm palpable liver tip. but is otherwise unremarkable Laboratory studies show an elevated fasting glucose with a mild elevation of transaminase This patient is at risk for developing which of the following,

A. Hyperthyroidism
B. Hypertrophic cardiomyopathy
C. Iron deficiency anemia
D. Testicular cancer
E. Vibrio vulmficus infection
 
#3 ·
A 58-year-old man comes to the clinic complaining of erectile dysfunction Over the past 6 months he has tried sildenafil and testosterone as well as a variety of herbal medications, but has had no success with these treatments Review of systems reveals complaints of some mild arthralgias and fatigue. which the patient has attributed to old age Examination reveals some mildly yellow-pigmented patches on the torso as well as a firm palpable liver tip. but is otherwise unremarkable Laboratory studies show an elevated fasting glucose with a mild elevation of transaminase This patient is at risk for developing which of the following,

A. Hyperthyroidism
B. Hypertrophic cardiomyopathy
C. Iron deficiency anemia
D. Testicular cancer
E. Vibrio vulmficus infection
This patient has Hemochromatosis, and is in high risk of contracting an infection by these 3 organisms

  1. V.Vulnificus
  2. L.Monocytogenes.
  3. Y.Enterocolitica
The most common cardiomyopathy related with Hemochromatosis is Dilated cardiomyopathy not hypertrophic and the most common cardiac defect is AV block
 
#6 ·
It was discussed few weeks ago.
It's actually both. It starts off as restrictive and eventually enough Iron deposits to cause free radical damage to the mitochondria and mitochondrial damage is one of the initiating points in DCM. That's why people with friedrich's ataxia also get DCM because they have a mutation in the gene frataxin that affects integrity of mitochondria.
Dilated Cardiomyopathy

Dilated cardiomyopathy causes
 
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#8 ·
Answer is E Vibrio vulnificus infection.

Thsi patient has hemochromatosis .

Iron overload of macrophages can interfier with phagocytosis and high serum iron level may increase susceptibility to bacterial infection.

Vibrio vulnificus and yersinia enterocolitica are iron loving bacteria
 
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