WBR1007

Author	[[PageAuthor::Vidit Bhargava, M.B.B.S [1]]]
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Dermatology, SubCategory::Hepatology
Prompt	[[Prompt::A 35 year old female presents with a 2 week history of sensitivity to sunlight. Whenever she steps outside unprotected she develops blistering, scarring, pigmentation on the back of her hands and face. She has also noticed increased hair growth at unusual places during these past 2 weeks. She is sexually active and takes oral contraceptives regularly. The physician orders the following labs: Complete blood count: Hemoglobin 12.0 mg/dL Hematocrit 45% RBC's 4 million/cc WBC's 8000 /cc Platelets 3 lac/cc LFT's AST 100 IU/L ALT 90 IU/L Prothrombin time 20 secs Bilirubin 2.0 Urinalysis: Color - pale pH – 5 Specific gravity – 1.010 Ketones – None Nitrates – Negative Leukocyte esterase – Negative WBCs - 3 WBCs/hpf Casts – 0-5 hyaline casts/lpf Crystals – none Uroporphyrin Elevated Porphobilinogen Normal USG: Normal liver architecture The patient is diagnosed with an enzymatic defect in heme metabolism, which of the following steps must be taken to treat this condition? ]]
Answer A	AnswerA::Stop oral contraceptives
Answer A Explanation	AnswerAExp::
Answer B	AnswerB::Use barrier sun protection
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::Phlebotomy or Deferoxamine to remove iron
Answer C Explanation	AnswerCExp::
Answer D	AnswerD::Chloroquine as it increases the excretion of porphyrins
Answer D Explanation	AnswerDExp::
Answer E	AnswerE::All of the above are true
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::E
Explanation	[[Explanation:: Educational Objective: References: ]]
Approved	Approved::No
Keyword
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::