USMLE images

[Zuhal]

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

 

[Zuhal]

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?

 

[Zuhal]

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?

 

[BelieveTheHype]

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.

 

[Ycut]

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

 

[tarsuc]

cool thread.!

 

[Zuhal]

where is this ischemia likely to happen? im looking for an anatomical location

 

[Goober11]

where is this ischemia likely to happen? im looking for an anatomical location

Splenic flexure. It's a watershed region between the IMA and SMA.

Great thread!

 

[BelieveTheHype]

A healthy 50 year old male comes into the clinic with symmetric lesions over both his knees.

 

[au3s]

Psoriasis?

 

[Zuhal]

59 y/o anemic pt presents to your clinic with a red, beefy tongue. what's ur differential dx

 

[Zuhal]

Splenic flexure. It's a watershed region between the IMA and SMA.

Great thread!

Yep, yep yep!

 

[Zuhal]

Psoriasis?

I agree with you, red lesion covered by silver scaly skin does scream psoriasis. the symmetrical part though is kinda throwing me off?

 

[Bluesclera]

plummer vinson syndrome for beefy red tongue

 

[BelieveTheHype]

Psoriasis?

Good job!

 

[Zuhal]

plummer vinson syndrome for beefy red tongue

yep thats one, what else?

 

[Ycut]

Diagnosis ?

 

[Ycut]

yep thats one, what else?

Vit. B2 defficiency

 

[Jonari]

View attachment 22478

Diagnosis ?

wilson's?

 

[Ycut]

wilson's?

No its not kayser fleischer ring

 

[Zuhal]

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

 

[Ycut]

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

 

[Zuhal]

View attachment 22478

Diagnosis ?

is this a smoker with a high lipid profile?

 

[Ycut]

As far as i remember b2 is giving glositis and magenta colored tongue

 

[Ycut]

Nonsmoker
Without any environmental risk factor

 

[Zuhal]

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

 

[Zuhal]

As far as i remember b2 is giving glositis and magenta colored tongue

yes but how does it give you anemia?

 

[Ycut]

yes but how does it give you anemia?

🙂 im not saying its giving anemia

Just made a guess from picture

 

[Ycut]

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

b6

 

[Ycut]

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

 

[Zuhal]

b6

That's it! Sideroblastic anemia

 

[Jonari]

Nonsmoker
Without any environmental risk factor

How'd you come to this conclusion, because I had no idea what I was looking at...

 

[Ycut]

Person in the image presented has macroglossia

 

[Jonari]

Person in the image presented has macroglossia

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

 

[withrye]

View attachment 22478

Diagnosis ?

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?

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.

 

[Ycut]

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

 

[Ycut]

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

 

[BelieveTheHype]

Yes
Brushfield spots

Any idea why this happens in Down's patients?

 

[Ycut]

Any idea why this happens in Down's patients?

No idea

 

[Zuhal]

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

 

[Zuhal]

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

 

[Ycut]

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

Diverticulosis

 

[Ycut]

In addition which disease can be present with this condition ?

 

[Ycut]

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

Target cells
Thalassemia asplenia - excessive membrane
liver disease-abnormal membrane

 

[rabbittrails]

anemias associated with glossitis
megaloblastic anemia folate b6 deficiency
pernicious anemia from failure to absorb b12
iron deficiency anemia

 

[Zuhal]

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?

 

[Ycut]

Abscess

 

[MLT2MT2DO]

View attachment 22487

In addition which disease can be present with this condition ?

Babesia

 

[Zuhal]

Abscess

yep. Foul smelling sputum was obtained. what microbe is most likely responsible for these findings?

 

[loveoforganic2]

View attachment 22487

In addition which disease can be present with this condition ?

Babesia

Beat me, my guess too