USMLE forum
 
USMLE Forum
Step 1
Step 2 CK
Step 2 CS
Matching & Residency
Step 3
Classifieds
 
Archives
 
 
  <<   < *  Step 2 CK   *  >   >>  

* nbme 4 section 1 q45
 #642155  
  vera - 12/22/11 21:56
 
  A 52-year-old man comes to the physician because he has had a 14-kg (30-lb) weight loss during the past 6 months. He has noticed oily, floating stools during the past 2 months. He received the diagnosis of acute pancreatitis 2 years ago and has had 1- to 3-hour episodes of severe abdominal pain since then. Current medications include oxycodone. His mother has type 2 diabetes mellitus, and his father died of alcoholic cirrhosis. The patient has smoked one pack of cigarettes daily for 30 years. He has alcoholism but has been abstinent for the past 2 years. He is 173 cm (5 ft 8 in) tall and weighs 59 kg (130 lb); BMI is 20 kg/m2. His pulse is 100/min, and blood pressure is 120/80 mm Hg. The abdomen is scaphoid with mild diffuse tenderness. The liver edge is firm and is palpated 2 cm below the right costal margin. Laboratory studies show:

Hematocrit
32%
Mean corpuscular volume
83 μm3
Leukocyte count
10,300/mm3
Platelet count
302,000/mm3
Serum

 Na+
139 mEq/L
 K+
3.5 mEq/L
 Cl−
108 mEq/L
 HCO3−
19 mEq/L
Urea nitrogen
22 mg/dL
Glucose
164 mg/dL
Creatinine
1.1 mg/dL
Alkaline phosphatase
120 U/L
AST
23 U/L
ALT
29 U/L
Amylase
90 U/L
Ferritin
250 ng/mL
Lipase
43 U/L (N=14280)

Which of the following is the most appropriate next step in management?

A
) Dietary supplementation with a multivitamin with iron

B
) Gluten-free diet

C
) Insulin therapy

D
) Pancreatic enzyme replacement therapy

E
) Parenteral nutrition
 
Report Abuse

 
 

* Re:nbme 4 section 1 q45
#2549718
  danayu69 - 12/22/11 22:17
 
  DD  
Report Abuse

* Re:nbme 4 section 1 q45
#2549734
  raheem - 12/22/11 22:29
 
  DD.........WHAT IS THE DIAGNOSIS?  
Report Abuse

* Re:nbme 4 section 1 q45
#2549998
  rawalian - 12/23/11 12:11
 
  aint it ch. pancreatitis  
Report Abuse

* Re:nbme 4 section 1 q45
#2549999
  rawalian - 12/23/11 12:13
 
  answer is DD...
 
Report Abuse

* Re:nbme 4 section 1 q45
#2571792
  genewalking - 01/23/12 17:47
 
  bump  
Report Abuse

* Re:nbme 4 section 1 q45
#2571807
  genewalking - 01/23/12 17:57
 
  what are the indications for insulin therapy in chronic pancreatitis  
Report Abuse

          Page 1 of 1          

[<<First]   [<Prev]  ... Message ...  [Next >]   [Last >>]

 
Logon to post a new Message/Reply
 
 
 
 

 

 

Google
  Web USMLEforum.com
 

Step 1 Step 2 CK Step 2 CS Matching & Residency Step 3 Classifieds
LoginUSMLE LinksHome