GI Question - roopert

[ArchivalUser]

i can apply different logics to answer this q but all of them `ll be wrong b/c none of us `ve studied about these options.

[ArchivalUser]

Thanks everyone for your attention. I appreciate everybody's comments (especially constructive ones) that help get us closer to the true answer to this instructional question. One of the aspects of the question that has tended to be addressed less adequately is probably the hypercalcemia concurrent with pre-eclampsia in this patient.
The differential diagnosis for hypercalcemia is rather extensive but when placed in this clinical scenario, it can be ascribed to the amount of calcium releaesed from the pelvic and abdominal muscles while the patient was going through labor.

Imagine having to deliver a baby in such advanced age through the ejaculatory duct. Lots of muscle strain and concommittant release of calcium will result. I bet if the lactate dehydrogenase levels are measured, they will also be high. Similar to a rhabdomyolysis picture. Most likely, because he is 63, some component of benign prostatic hypertrophy will make the duodenoprostatic delivery even more difficult.

All comments on this are welcome.

[ArchivalUser]

how can d be the answer? we are talkin abt a male here. pre eclampsia is in females and during pregnancy

[ArchivalUser]

to shilpi, I think u didn't get the point.......the Q stem has tactfully evaded the fact the 63 year old guy was a transexual!!!

to roopert, ... what stuff r u taking nowadays buddy....

[ArchivalUser]

pardon me. my knowledge of medicine must be very obsolete. I used to think that preeclampsia is a disease of pregnant women. the patient is male. please can somebody throw more light on this HYPERCALCAEMIC PREECLAMPSIA?
By elimination, I will go for b although i don't exactly know what a duodeno-ophthalmic ligament is. can somebody still throw more light on it? it sounds like from the duodenum to the eye. hmmm.

[ArchivalUser]

to kishmish,
hey so u think they r actually referring to a transexual without even mentioning he is one.and more so they r saying he is pregnant at this advance age. they really ask such hypothetical questions without being clear abt them. im scared now, i mean i wouldn't have really thought in tht direction.guess preparing for mle's is gonna be a real traumatic experience

[ArchivalUser]

Since I have become interested in this thread and I kind of follow what people have to say about this question, I cut and paste a comment from an earlier parton named "ShepShep" or "Gooz" if I'm not mistaken, that explains the confusion with the patient in question being transexual:

Gooz earlier said the following:

PRE-ECLAMPSIA in a 63-year-old male can occur if a 62-year-old male homosexual transvestite undergoes bilateral radical orchiectomies and sexual reassigment surgery followed by uterine, fallopian tube, and ovarian transplantation with vulvo-vaginal reconstruction surgery. He (Now SHE) then will ovulate under clomiphene treatment and will be inseminated by her male partner (yes, now they have vaginal intercourse). The next year, she will be pregnant and 63, AND given the right amount of alpha(1)-adrenergic agonists (for induction of hypertention) and nephrotoxic agents (for proteinuria), pre-eclampsia will ensue.

But I don't think that is correct. My deliberation and discussion of this case follows:

This is actually a very rare case of the disease called "Early-onset Duodeno-prostatic Pregnancy." There has been only one reported case of this disease and that is in this individual.
When occuring in due time, duodenoprostatic pregnancies are benign and self-limiting. The patient will eventually be dilated and will have a normal delivery through the ejaculatory duct.
However, if an early-onset episode of this syndrome occurs (usually due to frequent anal intercouse and entrapment of flatus in rectal folds and diverticula) the disease manifests in this particular way and emergent surgery by jaws of life is required to separate the patient from their hyperactive partner.

[ArchivalUser]

This question stem is totally ridiculous. Some guy here wants to prove something. A wild idea. I don't know , for some self-made research program or stuff like that. He's crazy.
To roopert, Quit trying to be Einstein.

[ArchivalUser]

hey why do we even think of pre eclampsia in a 63 yr old male