Internal Medicine-Gastrointestinal Q #5 - 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 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 12-03-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 387
Threads: 82
Thanked 618 Times in 234 Posts
Reputation: 628
Arrow Internal Medicine-Gastrointestinal Q #5

A 21-year-old man presents to the Medicaid clinic feeling tired and generally unwell. He has fallen several times over the past month and has developed a slight tremor in both hands. Physical examination is significant for scleral icterus, ankle edema, and a distended and tense abdomen. Laboratory studies show:
Hemoglobin 7 g/dL
Reticulocyte count 7%
Total bilirubin 3.1 mg/dL
Aspartate aminotransferase 84 U/L
Alanine aminotransferase 92 U/L
Ceruloplasmin 5 mg/dL
(normal: 20Ė45 mg/dL)
Coombs test Negative
What is an appropriate preventive management step after chelation therapy?

(A) Blood protein electrophoresis
(B) Colonoscopy
(C) Electrocardiogram (ECG)
(D) Schilling test
(E) Upper endoscopy
Reply With Quote Quick reply to this message
The above post was thanked by:
usmle2011 (12-03-2012)



  #2  
Old 12-03-2012
Hitman's Avatar
USMLE Forums Master
 
Steps History: Not yet
Posts: 928
Threads: 17
Thanked 539 Times in 375 Posts
Reputation: 549
Default

Ans E ......to check for varices ....
Reply With Quote Quick reply to this message
  #3  
Old 12-03-2012
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 512
Threads: 57
Thanked 319 Times in 163 Posts
Reputation: 329
Default

E seems better to look up for varices
Reply With Quote Quick reply to this message
 
  #4  
Old 12-04-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 387
Threads: 82
Thanked 618 Times in 234 Posts
Reputation: 628
Default

The correct answer is E.

This patientís presentation and laboratory tests all point to Wilsonís disease, a disease characterized by copper accumulation in multiple organs, especially the liver and brain, due to defective excretion of this metal. Along with basal ganglia dysfunction and hemolytic anemia, this patient is showing signs of portal hypertension due to cirrhosis caused by copper accumulation in the liver. This increase in pressure in the portal circulation leads to variceal formation at the junctions of the portal and systemic circu-lations. An upper endoscopy should be performed to monitor for esophageal varices that could be treated prophylactically or closely monitored to prevent life-threatening bleeding.
Reply With Quote Quick reply to this message
The above post was thanked by:
aknz (12-04-2012), goulartmd (12-04-2012)
  #5  
Old 12-05-2012
USMLE Forums Scout
 
Steps History: ---
Posts: 84
Threads: 2
Thanked 38 Times in 36 Posts
Default

Quote:
Originally Posted by heartbeat View Post
A 21-year-old man presents to the Medicaid clinic feeling tired and generally unwell. He has fallen several times over the past month and has developed a slight tremor in both hands. Physical examination is significant for scleral icterus, ankle edema, and a distended and tense abdomen. Laboratory studies show:
Hemoglobin 7 g/dL
Reticulocyte count 7%
Total bilirubin 3.1 mg/dL
Aspartate aminotransferase 84 U/L
Alanine aminotransferase 92 U/L
Ceruloplasmin 5 mg/dL
(normal: 20–45 mg/dL)

Coombs test Negative
What is an appropriate preventive management step after chelation therapy?

(A) Blood protein electrophoresis
(B) Colonoscopy
(C) Electrocardiogram (ECG)
(D) Schilling test
(E) Upper endoscopy
i think it should be C.
ok got it now. its E. again didnt read it properly.
Reply With Quote Quick reply to this message



Reply

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
5 CM Pancreatic Cyst heartbeat USMLE Step 2 CK Forum 9 12-06-2012 10:53 PM
Internal Medicine-Gastrointestinal Q #4 heartbeat USMLE Step 2 CK Forum 5 12-04-2012 09:53 AM
Gall Stones Pancreatitis heartbeat USMLE Step 2 CK Forum 6 12-04-2012 09:23 AM
Internal Medicine-Gastrointestinal Q #3 heartbeat USMLE Step 2 CK Forum 5 12-03-2012 09:06 AM
Internal Medicine versus Emergency Medicine Residency appu IMG Residency Match Forum 3 06-16-2011 07:34 AM

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)