Peeshee

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HI,
in the new Robbins pathology question book, the final exam of 74 questions, question # 70, I was wondering what you think the answer is..
here is the question;

A 5 yo child who has rec'd no med care since birth has had gradual onset of markedly decreased vision bilaterally. The child also has a history of increased resp tract infections due to H influenza, Strep pneumo, Klebsiella pneumo, rubeola. The representative microsopic appearance of the bronchial mucosa is shown. The child also has passed several urinary tract calculi. On physical exam, generalized papular dermatosis is noted. The child has xerophthalmia, and there is marked keratomalacia with corneal clouding. Bilateral crackles are audible in the lungs on auscultation. Which of the following disease processes is most likely to lead to these findings?

a-cystic fibrosis
b-congenital syphilis
c-hiv infection
d-kartagener syndrome
e-vit. A deficiency
.............................................ok, here is what i thought..............................................
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I thought answer was cystic fibrosis, bec. of resp infections and thought also that he had fat soluble vitamin deficiency (which they explain as vitamin a deficiency)....but the answer is vit. a deficiency. But, maybe, I should've seen that he rec'd no medical care and suspected poor nutrition bec. of that...I just thought this question was a little tricky......any comments?
thanks
 

automaton

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from first aid: vit a deficiency - night blindness, dry skin, impaired immune response

from high yield biochemistry - night blindness, xerophthalmia, progressive keratinization of the cornea, follicular hyperkeratosis, decreased resistance to infection, increased susceptibility to cancer

seems like a tough but fair question.
 

omarsaleh66

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Peeshee said:
HI,
in the new Robbins pathology question book, the final exam of 74 questions, question # 70, I was wondering what you think the answer is..
here is the question;

A 5 yo child who has rec'd no med care since birth has had gradual onset of markedly decreased vision bilaterally. The child also has a history of increased resp tract infections due to H influenza, Strep pneumo, Klebsiella pneumo, rubeola. The representative microsopic appearance of the bronchial mucosa is shown. The child also has passed several urinary tract calculi. On physical exam, generalized papular dermatosis is noted. The child has xerophthalmia, and there is marked keratomalacia with corneal clouding. Bilateral crackles are audible in the lungs on auscultation. Which of the following disease processes is most likely to lead to these findings?

a-cystic fibrosis
b-congenital syphilis
c-hiv infection
d-kartagener syndrome
e-vit. A deficiency
even if u dont know about vit A def., u can rule out cystic fibrosis cuz the kid has no infection w pseudomonas aureginosa. Also, its a gradual onset and he is 5 years old, most of the answer choices are congenital defects and they would have been present at birth. Just thought I would add that to what automaton said above. Also, thanks automaton for that info, Im not going to forget about vit. A now!!

later
 

carrigallen

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I agree - kids with cystic fibrosis usually have recurrent bouts of psuedomonas infections.
 

HiddenTruth

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xeropthalmia and keratomalacia should have given it away--those are classic for vit a deficiency. But, i can see ur cystic fibrosis guess. Also, a lot of times, they hint towards cystic fibrosis with "increased Cl- concentration", or sweat Cl- test was positive, something like that. Just a heads up.

By the way, is the new robbins a totally NEW set of 1100 q's? Damn, that's a hella new questions.