USMLE Step 1 QUESTION of the DAY!

A new patient tells you he has an autosomal recessive disorder that caused his liver disease. He is now complaining that he has had tremors and muscle spasticity. He also notes that his vision is getting worse and worse. Which of the following would you most likely expect to find?

A) bronze diabetes
B) kayser-fleischer rings
C) nutmeg liver
D) increased ceruloplasmin
E) emphysema

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Answer: B) Kayser-Fleischer rings. This man most likely has Wilson’s disease, an autosomal recessive disorder of copper metabolism. There is an accumulation of copper (but a decrease in serum ceruloplasmin) which deposits in the liver, basal ganglia, kidney, and cornea (kayser-fleischer rings). Bronze diabetes is seen in hemochromatosis; Nutmeg liver usually manifests in congestive heart failure (most often right sided); emphysema is noted in alpha-1 Antitrypsin deficiency.



USMLE Step 1 D.O.C. of the DAY!

Drug of choice for

Shigella causing dysentery

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Trimethoprim/sulfamethoxazole


FACT of the DAY!

Reye’s Syndrome
-this is why you don’t give children aspirin for viral infections or any reason for that matter
-characterized by fulminant hepatitis and cerebral edema
-use acetaminophen instead