ophthalmology q

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ophthalmology q

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8 Posts

angel23
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Topics: 42
Posts: 977

07/19/08 - 02:58 PM

a 38 yr old female is an usher at a local movie theatre,has BMI of 34kg/m2 and has been on orlistat for last 6 months.she comes to the office complaining of difficulty driving in low lights.she reports multiple small accidents while working during the movie function.
review of symptoms reveal mild ecchymosis and dryness of eyes.past H/O impaired glucose tolerance and hyperlipidemia.she also reports of smoking marijuana once a week.
visual examination is indicative of difficulty reading letters in dim lights and sclera shows white patches.conjunctiva is dry.corneal and retinal exam is normal
labs are:
Hb:10.5
Hct 34%
paltelets :2,20000
WBC 5000
neutrophils 58%
eosinophils 1%
lymphocytes 30%
PT 16sec
PTT 37 sec

which of the following is most likely cause of pts symptoms

1.adverse drug reaction
2.cataract
3.diabetic retinopathy
4.vit A def
5.VIt B12 def
6.Vit C def
7.retinitis pigmentosa

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Eagle_303
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Topics: 77
Posts: 646

07/19/08 - 03:33 PM

Night blindness + Bitot spots on the cornea = vit A deficiency which is because of lipid malabsorption (orlistat)

Best of luck

angel23
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07/19/08 - 03:37 PM

answer is A. adverse drug reaction because of orlistat there is def of both vit A and Vit k(prolonged PT,ecchymosis)

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Eagle_303
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07/19/08 - 03:42 PM

angel23 wrote:
answer is A. adverse drug reaction because of orlistat there is def of both vit A and Vit k(prolonged PT,ecchymosis)

absolutely true ,I did not pay attension to increased PT and echymosis.

Eagle_303
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Topics: 77
Posts: 646

07/19/08 - 04:33 PM

BTW angel how can we say ecchymosis or night blindness as the "ADVERSE EFFECTS" of Orlistat.

Orlistate --------------> pancreatic lipase inhibition in the intestine -----------> Lipid malabsorption ----------> decreased in absorption of vit k ---------------> increase in PT --------------> Ecchymosis .

In the same way

Orlistate -----------> pancreatic lipase inhibition -------------> lipid malabsorption -----------> decreased absortpion of vit D -------------> osteomalacia and body deformities --------->contracted pelvis -------------> Obstructed labor

Are you sure that this obstructed labor can be called as "ADVERSE EFFECT of Orlistate ??

angel23
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07/19/08 - 04:57 PM

i dnt know this was the answer given in kaplan qbank....
i was confused so i asked...
i cud not get adverse drug reaction

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angel23
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Topics: 42
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07/19/08 - 05:07 PM

i think it will be an adverse drug reaction....
coz all these are actually adverse effects of orlistat
wat u say??

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Pioglitazone
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Topics: 6
Posts: 66

07/20/08 - 12:02 AM

Answer SHOULD be Vit A deficiency. Eagle has a point! There's a difference between an adverse effect and a consequence of taking a drug.

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