me007
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A 48 yr old woman injured her right wrist in a fall down a flight of stairs.
On physical examination, she has marked pain on palpitation of the wrist and does not want to move the hand. A radiograph of the right hand and arm shows marked osteopenia and a fracture of the radial head.
Which of the following underlying diseases is most likely to contribute to the risk of fracture in this pt ?
a. coronary atherosclerosis
b. pulmonary emphysema
c. primary biliary cirrhosis
d. chronic lymphocytic leukemia
e. atrophic gastritis
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| Luckyall
Forum Guru
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where is this Qs from? ve seen it before is it C ?
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| Ancylostoma
Forum Guru
Topics: 42
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D I really dont know the answer had a feeling that it could be D, thought about the others but I guess your going to tell me if I'm wrong. Make sure you explain the answer!!
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| me007
Forum Guru
Topics: 72
Posts: 799
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don't have an explanation and don't know were the q from, it is not nbme, c is correct.
i'm trying to find why it is c
common findings in primary biliary cirrhosis include hyperlipidemia, hypothyroidism, osteopenia, and coexisting autoimmune diseases
(hypothyroidism which is likely due to autoantibodies -->hypocalcemia)??
also
The risk of osteopenia and osteoporosis is increased in patients with primary biliary cirrhosis (who tend to be older women) possibly due in part to polymorphisms of the vitamin D receptor.
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| Ancylostoma
Forum Guru
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maybe damage to the liver, decrease 25 oh activity, leads to decrease vitamin d . I thought it might be a possibility , I thought cll could cause osteopenia and fractures too maybe it was another leukemia.
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| me007
Forum Guru
Topics: 72
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fat-soluble vit D deficiency
in pt with biliary obstruction
fits?
is there osteopenia in CLL?
we have bone marrow smears but what about x-ray?
Edited by me007 on 01/30/07 - 09:53 PM
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| Ancylostoma
Forum Guru
Topics: 42
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complication of Primary biliary cirrhosis is cirrhosis, I thought maybe it was a possibility, looking at my notes though It looks like I added this complication in. The reason I put was decrease vit d absorbtion..that means I must of read it somewhere...will check resources
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| Ancylostoma
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I found the answer, I dont know why it was so difficult and am sorry to say I feel stupid. Lol its osteomalacia related to malabsorbtion of vitamin d . Just like I had written in my notes. Other fat coluble vitamin deficiencys may also be present. source Robbins but its obvious, bile salt def is one of the causes of malabsorbtion.
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| me007
Forum Guru
Topics: 72
Posts: 799
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House M.D. on FOX
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| Ancylostoma
Forum Guru
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Great show!!
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| MRMAVERICK
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| Feyza
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heyy ppl...I feel soo down ! the info that osteoporosis is a common complication of PBC is in neither Kaplan notes nor in BRS...but in big textbooks  how many this detailed Qs do you think we will face in the exam?? wut am I gonna do when there is only 4 months left 4m ??
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O my Lord! Open my chest for me ( grant me self-confidence ) and ease my task for me.Ta-Ha 25-26.
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| new_n_lost
Forum Hero
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Switch to Goljan i mean just review Goljan for path and AS regards to Robbins which sort of a basic book for reference and topics u can only look for & at the topics missed by Goljan if they r any.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| Feyza
Forum Guru
Topics: 49
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new-n-lost ! thanx 4 the advise but I have only 3 months !! do you think its really worth to switch now ?!?!? or should I w.e stick to Kaplan which I already read once?? I wish I saw this forum far b4  cuz now I feel Ill never pass with only Kaplan...ppl here told me they were ok so I never thought of any other book for any lesson but now I lost my belief
btw ...what is AS??
thanx and best wishes for steps ! 
___________________
O my Lord! Open my chest for me ( grant me self-confidence ) and ease my task for me.Ta-Ha 25-26.
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