USMLE images

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Zuhal

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68 yo male patient presents to your clinic with postprandial pain. X-ray below, whats the dx?

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8 y/o boy is brought to the doc by his parents, pallor fatigue and dyspnea on p/e. doc orders labs+ blood smear(see image). whats the dx? and what will the pt's labs look like? Serum iron? Ferittin? TIBC? % saturation?
 

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25 y/o male regular pt presents to your office w/ SOB, pallor and lethargy. See image

what's the dx?
what are some possible treatment complications?
 

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1. That is the "thumb print" sign (edematous mucosa) --> due to ischemia
3. "Hair on end" appearance - B-Thalassemia. Tx can cause secondary hemochromatosis due to the need for repeated blood transfusion.
 
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8 y/o boy is brought to the doc by his parents, pallor fatigue and dyspnea on p/e. doc orders labs+ blood smear(see image). whats the dx? and what will the pt's labs look like? Serum iron? Ferittin? TIBC? % saturation?

Sideroblastic anemia (lead poisoning)
Serum iron increased Ferittin increased
TIBC decreased
% sat increased
 
where is this ischemia likely to happen? im looking for an anatomical location
 
59 y/o anemic pt presents to your clinic with a red, beefy tongue. what's ur differential dx
 

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Vit. B2 defficiency

B2 gives you glossitis, however i don't think you can get anemia from b2 deficiency. but you're very close. I'm looking for a vitamin deficiency that will give you glossitis AND anemia
 
B2 gives you glossitis, however i don't think you can get anemia from b2 deficiency. but you're very close. I'm looking for a vitamin deficiency that will give you glossitis AND anemia

Vit C
 
Vit C can give you anemia but not glossitis as far I know. I'll give you another hint
this vitamin is used for an important inhibitory neurotransmitter synthesis

Vitaminc C deficiency can cause painful glossitis
 

This pic needs the other eye included, so we can see if the pupil is equal, constricted, or dilated compared to the other eye. It's also impossible to tell whether the ptosis is one sided.

Assuming it's unilateral ptosis and miosis, however, I'd say Horner's.

EDIT: MAYBE Brushfield spots in the outer iris, indicating Down Syndrome?

Jonari said:
Could you please answer how the picture of the eye can tell you a person is a non-smoker without any environmental factors, please?

I think Ycut was clarifying that this isn't in the context of a smoker or an environmental exposure. It was to offer context, not some deduction based on the image alone.
 
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Could you please answer how the picture of the eye can tell you a person is a non-smoker without any environmental factors, please?

He may even have thousands of risk factors but what i wanted to say is for this particular disease there are no environmental risk factors
 
This pic needs the other eye included, so we can see if the pupil is equal, constricted, or dilated compared to the other eye. It's also impossible to tell whether the ptosis is one sided.

Assuming it's unilateral ptosis and miosis, however, I'd say Horner's.

EDIT: MAYBE Brushfield spots in the outer iris, indicating Down Syndrome?



I think Ycut was clarifying that this isn't in the context of a smoker or an environmental exposure. It was to offer context, not some deduction based on the image alone.

Yes
Brushfield spots
 
in what hematological condition do you see the cells in the image? whats the pathophysiology?
 

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male pt presents to your office with a 3 day h/o painless hematochezia. see braium enema results. whats the dx?
 

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anemias associated with glossitis
megaloblastic anemia folate b6 deficiency
pernicious anemia from failure to absorb b12
iron deficiency anemia
 
Came across this question in a qbank, thought I'd share it with you guys...

58 y/o smoker
cough/SOB
h/o alcoholic liver cirrhosis
xray below.

what's the dx?
 

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