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Kaplan Qbank USMLE



Author8 Posts
  #1

A 40 yo(year old) alcoholic womman presents with intense pruritis and fatigue.her medical history is significant for hypothyrodism,P/E reveals a slightly enlarged liver and xanthomas.laboratory study shows cholesterol 538mg/dl

Alkaline phosphatase 571IU/l.which of the following serum value would most likely be elevated?

a.alpha-fetoprotein

b.anti-mitrocondrial antibody

c.HBsAg

d.prothrombin time

e.serum transaminases


  #2

No one knows or not interested at all???

  #3

d and e should both rise, but transaminases may show up first due to alcoholic liver failure first.. so ill guess e. i dont get why the alk phos would go up.. is it cause of excess cholestrol to a point its screwing up the common bile duct?

___________________
Matrix 101 - The Medical school http://www.youtube.com/watch?v=mdJyyJ2qur0

  #4

consistent with PBC
middle-aged women with autoimmune disease , pruritus (early sign in PBC), fatique, xantelasma, and ALK-P elevation about 10-fold

i guess b

  #5

me007 wrote:
consistent with PBC
middle-aged women with autoimmune disease , pruritus (early sign in PBC), fatique, xantelasma, and ALK-P elevation about 10-fold

i guess b

Yup If choice B is antimitochondrial antibodies then by looking at the clinical picture this is a case of PBC which also has a hypothyroidism as a component due to the HLA DR8 association.

This probably like a (sort of a) UW question, They tend to make u think laterally.


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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."

  #6

yes rt guys it is B.PBC,also patients with antimitrocondrial antibody do have hosimoto's thyroditis -->most common caus eof hypothyroidism.

nnl-its not UW question but KQbanksmiling face


  #7

keepgoing wrote:
yes rt guys it is B.PBC,also patients with antimitrocondrial antibody do have hosimoto's thyroditis -->most common caus eof hypothyroidism.

nnl-its not UW question but KQbanksmiling face

Haan i was guessing on that part good question though.

___________________
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."

  #8

In addition,
TREATMENT OF COMPLICATIONS — There are a number of complications that occur in PBC that require therapy. These include:

Pruritus
Metabolic bone disease
Hypercholesterolemia and xanthomas
Malabsorption
Vitamin deficiencies
Hypothyroidism
Anemia - Iron deficiency anemia








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