sandra
Forum Guru
Topics: 201
Posts: 470
|
A 72-year-old man comes to the physician with his wife because of chronic abdominal pain and
headaches for 4 months. His wife states that he has become more forgetful over the past 6 months.
He has a history of gout. He has smoked one pack of cigarettes daily for 50 years and drinks 10 oz
of homemade whiskey daily. He takes no medications. His temperature is 36.8 C (98.3 F), blood
pressure is 160/98 mm Hg, pulse is 74/min, and respirations are 16/min. Neurologic examination
shows mild short-term memory loss and decreased sensation to pinprick in the distal extremities.
He has an ataxic gait. There are gouty tophi on the dorsal aspect of the left elbow. Laboratory
studies show:
Hematocrit 33%
Mean corpuscular volume 70 μm3
Serum
Urea nitrogen (BUN) 17 mg/dL
Glucose 90 mg/dL
Creatinine 2 mg/dL
Uric acid 14 mg/dL
Which of the following is the most appropriate next step in management?
A
) Measurement of blood lead level
B
) Measurement of serum porphobilinogen level
C
) CT scan of the abdomen
D
) MRI of the brain
E
) Carbidopa-levodopa therapy
___________________
You become what you think you are!
|
| docnikki
Forum Guru
Topics: 93
Posts: 680
|
A)Measurement of blood lead level
the last step in Hemoglobin synthesis gets screwed with lead poisoning if I remember correctly...so that lead to the microcytic anemia.
He also has CNS symp and abd pain.
so looks like lead poisoningg.
|
| RX 135
tormenta
Topics: 33
Posts: 613
|
home moade wisky..periperal neuro
___________________
99/96/cs/ 2008grad/ 1mo usce/ need visa/ 1 pub on a loan!
|
| RX 135
tormenta
Topics: 33
Posts: 613
|
pb
___________________
99/96/cs/ 2008grad/ 1mo usce/ need visa/ 1 pub on a loan!
|
|
| |
| | | | |
