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  #1  
Old 08-13-2013
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Urine Sample Asian girl with dark urine

Based on an uw concept, but changed not to infringe on copyright.
------------------------------------------------------------

Asian 7 y.o. immigrant girl is brought by her parents to see you. She just moved in the country and was under a lot of stress. Her family friend has a 7 y.o. daughter with a blood disorder. She did not see doctor for a last few years and has never been vaccinated. Her parents noted that their daughter has a very dark urine and her eyes seem yellow for the past few days. You note scleral icterus and urine dipstic is positive for bilirubin.

What is her condition?

a) hemolytic anemia
b) thalassemia minor
c) Gilbert syndrome
d) thalassemia major
e) rotor syndrome
f) crigler-najar type 1
g) crigler-najar type 2

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  #2  
Old 08-13-2013
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Rotor
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Old 08-13-2013
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i think its rotor..
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Rotor
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Old 08-13-2013
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Rotor's Syndrome

Since the patient has a female relative who has the same condition, then I am assuming it is autosomal recessive and excluding Gilbert's syndrome. Since the jaundice is severe, then I am excluding Criglar Najar type 2. The final answer is Rotor's syndrome.
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Quote:
Originally Posted by M.Tayeb View Post
Rotor's Syndrome

Since the patient has a female relative who has the same condition, then I am assuming it is autosomal recessive and excluding Gilbert's syndrome. Since the jaundice is severe, then I am excluding Criglar Najar type 2. The final answer is Rotor's syndrome.
But, It's a family friend, not a relative. Is that the same thing?
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Its rotor.

The only meaningful explanation is right here:

conjugated billirubin is the only form of billirubin exctreted in urine.

not a family friend or neighbors dog usually do not affect one's urine
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  #8  
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Quote:
Originally Posted by doc007 View Post
But, It's a family friend, not a relative. Is that the same thing?
No it's not the same, I didn't pay too much attention to the question, good catch doc007. She is a girl anyway and can't be Gilbert's syndrome, what do you think?
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Smile

Excluding everything else I went with rotors bc of the bilirubin in urine can only be due to conjugated. All the other options are causes of unconjugated.
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Quote:
Originally Posted by DocSikorski View Post

not a family friend or neighbors dog usually do not affect one's urine
Hilarious !
Good question btw....
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Rotor's - the patient's age and the urine finding are suggestive for rotor
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----------------------------------
Ps. XpaezX - do not answer right away, let me torture a few minds in here

LOL!!!!!
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Old 08-13-2013
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nice question Doc siso
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Quote:
Originally Posted by billy View Post
nice question Doc siso
I might be a so-so doc, but Im still doc Sikorski...
A very common last name for an Eastern Europen... can't see how it can be so hard to read...

Glad you liked the q though
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Old 09-12-2013
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the history shows bilirubin in urin. it means that the patient has Direct hyperbilirubinemia, so we can rule out Gilbert disease, Crigler Najjar type 1 and 2 and hemolysis wich cause indirect hyperbilirubinemia. the answer is Rotor Syndrome
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Old 09-12-2013
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..............

Last edited by kid_next_door; 09-12-2013 at 09:28 AM.
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Hematology-, Pediatrics-, Step-2-Questions

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