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Discussion Starter #1
INPATIENT/ ER/ CLINIC/ OTHER - clinic
PATIENT PROFILE - 38 yo male, abdominal pain accompanied with nausea and vomiting, pain severe that started 20 hrs ago, unable to eat and drink since then, looks pale and hunched over on exam table, bp 92/56, pulse 120, resp 18, palpation of abdomen reveals diffuse tenderness, no point tenderness, no rebound tenderness, no guarding, stooloccult negative, during rectal exam had mild seizure with quick recovery
RELEVANT HX - no recollection of having seizure in the past
FAMILY HX - sisters had similar episodes intermittently since they were teenagers
QUESTION - what is the most likely cause of seizures?

A undiagnosed seizure disorder
B gastroenteritis
C electrolyte imbalance
D sequelae of ulcerative colitis
 

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Have no idea... Anyways my guess is...

A. undiagnosed seizure disorder
 

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Discussion Starter #6
this pt suffers from acute intermittent porphyria, a defect in metabolism of heme from rbc
nausea and vomiting and subsequent inability to consume liquids lead to severe dehydration and electrolyte imbalance
hyponatremia from vomiting
hypoglycemia from fasting
electrolyte imbalance can cause seizure-like episodes
 
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