2 questions from my Step 1 that are bothering me

[DarkKnight11087]

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I had a question about a patient who was given warfarin and developed side effects they asked for a treatment option to reverse the effects. the two choices i was between was.

A) cryoprecipitate
B) Vitamin K

I ended up choosing cryoprecipitate because i didnt think Vitamin K was acute enough to reverse the effects of the warfarin? waht do you guys think.

2nd question. Patient had a gross description of a keratin pearl on his temple. a picture was included, based on the gross description would you lean towards

A) squamous cell carcinoma
B) basal cell carcinoma

I ended up choosing B, because i remember grossly keratin pearly look being the decription for basal cell carcinoma but again i think i might have chosen wrong, what does everyone think?

 

[cstplove]

Cryoprecipitate is not used for warfarin. It only has factors VIII and fibrinogen. FFP plasma is typically used as the fastest way to replenish supplemented by vitamin K.

Sq. cell carcinoma of the skin is associated with keratin pearls, so is sq cell carcinoma of the lung.

also i think someone might get mad for posting Q.

 

[Ty Webb]

I think you're probably right about the lesion being basal cell carcinoma. Basal cell carcinoma is described pretty frequently as being "pearly". If we were talking histologic specimen that had "keratin pearls" then of course you'd be leaning towards squamous cell carcinoma.

 

[SirGecko]

Kerratin pearls are a histologic finding associated with scc. Did the question stem actually say that or did you just see a gross picture? If they actually said kerratin pearl the answer was scc. Pearly on the other hand is a gross finding and is basal cell. Sounds like you saw a gross picture that was pearly so basal cell was probably right.

As for the first one fresh frozen plasma should have been the right answer.

 

[ArcGurren]

I had a question about a patient who was given warfarin and developed side effects they asked for a treatment option to reverse the effects. the two choices i was between was.

A) cryoprecipitate
B) Vitamin K

I ended up choosing cryoprecipitate because i didnt think Vitamin K was acute enough to reverse the effects of the warfarin? waht do you guys think.

2nd question. Patient had a gross description of a keratin pearl on his temple. a picture was included, based on the gross description would you lean towards

A) squamous cell carcinoma
B) basal cell carcinoma

I ended up choosing B, because i remember grossly keratin pearly look being the decription for basal cell carcinoma but again i think i might have chosen wrong, what does everyone think?

1. Vit K is a better answer because cryoppt cannot reverse the effects of warfarin. FFP would have been a better choice.

2. SCC has keratin pearls, but BCC has a "pearly" appearance. Depends on if you had a gross or histo pic.

 

[rahuldp]

2. SCC has keratin pearls, but BCC has a "pearly" appearance. Depends on if you had a gross or histo pic.[/QUOTE]

although a loose association, but in one of lecture Goljan mentions, anything above Upper lip, like Nose etc..has more propensity of basal cell ...and if gross specimen appears pearly Basal cell more likely.

 

[BlondDoctor]

2 questions from my Step 1 that are bothering me

Only 2? Lucky you 🙂