On Calciphylaxis, and Ichthyosis

June 23, 2014

. . . . And then there’s lipoprotein(a), a diagnostic puzzle that involves acute abdominal pain and a CT scan in a woman with a complicated medical history, and skin lesions that look like coins. 5 questions in all. . . .

 

Question 1:

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Question 2:

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Question 3:

 

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Question 4:

A 73-year-old woman with a past medical history of GERD, hypertension, diverticulosis, and recurrent urinary tract infections presented with acute onset of nausea and vomiting. She had left upper quadrant pain that radiated to her left flank. Laboratory studies revealed a serum creatinine level of 1.21 mg/dL; AST and ALT levels, 57 U/L and 53 U/L, respectively; and LDH level, 1053 IU/L. Leukocyte count was 15,700/μL. A contrast-enhanced CT scan of the abdomen showed inhomogeneous uptake of contrast in the left kidney. Paroxysmal atrial fibrillation was noted on an ECG.

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Question 5:

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ANSWER KEY:

Question 1. E

Question 2. B

Question 3. A

Question 4. B

Question 5. C