DrVirgo
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BACD?
Elderly, abd pain, smoker, drinker of homemade whiskey, gout, HTN, memory loss, dec pin prick, ataxic gait, gouty tophi, dec. MCV = microcytic anemia.
Lead poisoning? Or what?
A- A . look for lead poisoning. The guys been having homemade whiskey for along time, that contains lead. Also microcytic anemia , ataxia, abd pain , headaches
B- Measurement of porphobilinogen level: those w/ acute intermittent porphyria could have an exacerbation of symptoms with the use of certain drugs i.e probenecid which this patient might use for his gout
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| robin082006
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C look for acid uric stone
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| doc_clotaire
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A -------------------typical presentation of LEAD POISONING
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| hanialkhadher
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| khorshid
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why not B?
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| Drtweetie
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My answer would be measuring porphobilinogen level:
q stem mentions pt w/ hx of gout, gouty tophi on elbow, elevated serum uric acid along with sxs observed in attacks of acute intermittent porphyria usually: abdominal pain, (2) psychiatric symptoms, such as hysteria, and (3) peripheral neuropathies, mainly motor neuropathies.
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| dr in trouble
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I think it is lead poisoning bcoz the age of onset for AIP is b4 40 yrs.AIP is an autosomal dominat conditionwhich mainly results in acute severe abdominal pain, motor neuropathy and psychotic symptoms
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| DrVirgo
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| coolmavs
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Lead poisoning, explains all the findings..microcytic hypochroic anemia, renal,abdominal pain, +++++ H/O home made whisky!
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