nbme 13 anemia/fainting concept

Discussion in 'Step I' started by abelabbot, 05.20.14.

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  1. abelabbot

    abelabbot Banned Banned Account on Hold 2+ Year Member

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    a 50 yr old dude w type 2 diabetes(longstanding) comes to the doc cuz of several fainting episodes and fatigue during the past month. Man appears really ill(not sick). His temperature is 98.F, pulse is 94/min and respirations are 17/min and blood pressure is 155?95. Physical exam shows pallor..

    then a bunch of values…low hemoglobin and hematocrit but increased mchc and mch…..increased creatinine…

    anyways, why the heck is the answer erythropoietin? I got it right because nothing else made sense but please do explain
     
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  3. EazyE1907

    EazyE1907 2+ Year Member

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    Erythropoietin is secreted secondary to when the kidney senses Low o2 content levels in the blood. Remember that o2 binding capacity to hb is a determinant of total o2 content in the blood, which = (o2 binding capacity to hb x % saturation of hb) + dissolved Po2. In this case, the patient has low hemoglobin, which means decreased o2 binding capacity to hb = decreased o2 content = erythropoietin secretion by the kidney to compensate for the loss. Another example of erythropoitetin secretion secondary to low o2 content would be living at high altitudes. Only this time the variable is not a decrease in o2 binding capacity but rather a decrease in Po2.
     
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  4. dyspareunia

    dyspareunia

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    What's the question?
     
  5. abelabbot

    abelabbot Banned Banned Account on Hold 2+ Year Member

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    BINGO
     

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