Case Study #1

[Mindy]

Thought this might be fun. Take a look at the attached .jpg and start the discussion.

Requisition: 38 yo male, recently abroad, with several weeks of diffuse abdominal pain, and new onset macrocytic anemia.

Which brave soul is going to lead us toward diagnosis?

Mindy

 

[rirriri]

hmmmm...

A) he has been abroad. (think infection)
B) abdominal pain (gastritis/colitis possible)
C) macrocytic anemia (possible b12 deficiency caused by gastritis)

i'm sleepy. leave me alone!! haha

so far, i seem to think that it is a case of Gastritis caused by infection and the anemia being secondary to that. I can't see that picture too well...do you have a bigger picture?

cheers!!

 

[Global Disrobal]

As I revert back to the Step 2 examination days, let me render a guess:

Possible Diphyllobothrium Latum Infection with the image showing the tapeworm's eggs in a stool study.

GD

 

[rirriri]

that's what that picture is!!!! (i couldn't see it well, my monitor sucks!)

YES! i agree.

 

[Global Disrobal]

For the record I am opposed to this format of questioning...I much prefer the multiple-guess format of the USMLE!

Global "The Human Tapeworm" Disrobal

 

[rirriri]

i would prefer a method by which they give you the answer and tell you to make a question!!

that would *really* test knowledge!

 

[Mindy]

Okay GD (and others!)

Okay, assuming this is D. Latum, is or is not the anemia important?

(okay... it is d. latum for crying out loud!)

Mindy

(Who's gonna put up the next case and how often should we or shouldn't do this?)

 

[Brian Pavlovitz]

Well, how timely! I just finished Parasitology a few weeks ago!

A great idea, too. Thanks, Mindy!

Brian

 

[tinwindow33]

Hi Mindy, could you check your pms, I sent you a pm a while ago...

 

[QuietSylph]

The anemia is significant, but should resolve with elimination of the parasite. It occurs because D. latum competes for dietary B12 with the host, which can eventually result in a megaloblastic anemia.

Nice case! Thanks for posting it!