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Kaplan Qbank USMLE



Author9 Posts
  #1

A 52 yo woman presnet to the ER 5 h after eating some grouper at a seafood restaurant while on vacation in Hawai . She has abdominal cramps , nausea , vomiting and watery diarrhea . She also complains of tingling and numbness of her lips and extremities . PE reveals a fine tremor and some mild ataxia . Which of the following is the most likely diagnostic in his patient ?

a ) Ciquatera poisonning

b ) Scromboid posonning

c ) Hemolytic uremic syndrome

d ) Traveler 's diarrhea

e ) Mycobacterium marinum

f ) Campylobacter jejuni

g ) Vibrio parahemofilus


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The elevator to succes is broke ,you must take the stairs

  #2

G

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The Key to Succeed is Patience.

  #3

I guess its B.

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Aim High

  #4

Please explain !


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The elevator to succes is broke ,you must take the stairs

  #5

sorry..just a hunch. No solid explanation!

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Aim High

  #6

A. Ciguatera poisoning can give you exactly those clinical findings.

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Any time something is written against me, I not only share the sentiment but feel I could do the job far better myself.

  #7

dont know the exact expplanation but by rule out i can reach to option A

  #8

a)The symptoms of ciguatera are gastrointestinal distress (nausea, vomiting) followed by neurological symptoms such as headaches, muscle aches, numbness, ataxia, and hallucinations. Severe cases of ciguatera can also result in hot-cold reversal, in which hot and cold sensations seem reversed.Hallmark symptoms of ciguatera include memory loss, muscle weakness, numbness, and extreme fatigue.

g)Infection with the Vibrio para-haemolyticus bacteria is most often associated with ingestion of raw or improperly refrigerated seafood. This illness usually occurs during the warmer months and is most common in the coastal regions of the United States. The primary symptom -- severe, watery, occasionally blood-tinged diarrhea -- generally occurs 12 to 24 hours after eating the contaminated food. The illness rarely lasts more than two days. In severe cases, antibiotics may be useful.

b)Scromboid, or histamine poisoning, is caused by bacterial spoilage of certain finfish, such as tuna, mackerel, bonito, skipjack, mahi-mahi, and bluefish.



Symptoms
Symptoms begin within 2 minutes to 2 hours after eating the fish, and may include rash, diarrhea, flushing of the face, and sweating, headache, dizziness, and vomiting. In addition, individuals may experience burning or swelling of the mouth, abdominal pain, or a metallic taste.

Most people experience mild symptoms which should resolve on their own within 12 hours. Symptoms may be more severe in patients taking certain medications that slow the breakdown of histamine by their liver, such as isoniazide and doxycycline.








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AAzad

  #9

Very nice explanation AAzad

There is nothing else to say

Answer is :A

Thanks !


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