Adam
Forum Senior
Topics: 6
Posts: 137
|
A 62-year-old man is seen for evaluation of severe back pain after coughing vigorously. In the emergency room he has a pathologic compression fracture of T6. Laboratory demonstrate:
Hgb: 8.7 Hct:38.7% WBC:6,200
Na:135 K:2.9 Cl:106 Ca:11.1 Phos.:1.4 Uric acid:1.5 Albumin:3.7
Co2:20. Glucose:88 BUN: 14, Cr:1.3
Urine analysis: PH: 7.0 Gr.: 1.008 Blood:negative Glucose: (+3).
The patient most likely has:
A. Liddle's syndrome
B. Bartter's syndrome
C. Fanconi syndrome
D. Gittelman's syndrome
E. Alport's syndrome
___________________
I will not say I failed 1000 times.. I will say that I discovered there are 1000 ways that can cause failure ..
|
| Aashi
Forum Moderator
Topics: 112
Posts: 921
|
D. Gittelman's syndrome
___________________
"Obstacles are those frightful things you see when you take your EYES off your goal."
|
| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
C. Fanconi syndrome <===> Acquired Cause ??? Drug Toxicity maybe
___________________
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."
|
| hanialkhadher
Forum Elite
Topics: 16
Posts: 256
|
D. Gittelman's syndrome
___________________
"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
|
| Adam
Forum Senior
Topics: 6
Posts: 137
|
I know it's a tricky question..
It's C: Fanconi Syndrome
This pateint has a pathologic fracture, anemia, and hypercalcemia, and those should immediately suggest a diagnosis of multiple myeloma. Renal complications of multiple myeloma include nephrotic syndrome, usually due to secondary amyloidosis, and myeloma kidney, which may cause cause renal failure without proteinuria, and Fanconi Syndrome.
Med-study Q&A 241
___________________
I will not say I failed 1000 times.. I will say that I discovered there are 1000 ways that can cause failure ..
|
| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
|
Yup the Only Thing Which cud Explain his Compressed Fracture was a Fanconi Syndrome which is a Combination of Multiple Electrolyte Transport Defects of many etiologies.
___________________
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."
|
| sprint123
Forum Guru
Topics: 129
Posts: 870
|
I have few questions..
Increased glucose in the urine---??Will it occur in nephrotic syndrome??
pls explain myeloma kidney?
Fanconi syndrome--Diagnosis only by lab investigation???
Thanx in advance
|
| Adam
Forum Senior
Topics: 6
Posts: 137
|
Increased glucose in the urine---??Will it occur in nephrotic syndrome??
Sure.. the renal causes of nephrotic syndrome is ( Minimal change, Glomerulosclerosis, Membranous GN,..... ) which they don't lead to increase glucose level in urine. BUT the systemic causes of nephrotic syndrome such as Diabetes (the most common), also Amyloidosis, Multiple Myeloma .. they MAY lead to increase glucose level in urine by different ways.
pls explain myeloma kidney?
I think it depends on pathology, I'll explain it soon (need to read more about it )
Fanconi syndrome--Diagnosis only by lab investigation???
I guess, the diagnosis of it is by exclusion, the MAIN renal problem of fanconi is RTA type2 ( renal tubular acidosis) . By the way, It may be Idiopathic, and Aquired. and Multiple Myeloma is one of the main causes of aquired fanconi syndrome.
___________________
I will not say I failed 1000 times.. I will say that I discovered there are 1000 ways that can cause failure ..
|
| Ivonne
Forum Guru
Topics: 52
Posts: 1,398
|
Nice question, thanks
___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)
|
| inkspot
Forum Guru
Topics: 26
Posts: 554
|
nice question!
i need to focus more on making association - i knew that mutiple myelomas have fanconi and i knew mm has fractures , but could not associate.
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
| underscore
Forum Junior
Topics: 13
Posts: 53
|
agree with inkspot. associations is the key. really a good question. keep posting
|
|
| |
| | | | | | | | | | | |
