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+--- Thread: GI PATH question - jdmed84 (/showthread.php?tid=685592)
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GI PATH question - jdmed84 - ArchivalUser - 07-01-2012
A 73-year-old woman with a history of aortic valve replacement complains of indigestion associated with fatty foods. She also notes several years of chronic fatigue. X-ray of the abdomen shows a cluster of nodular radiodensities in the right upper quadrant.
Which of the following most likely constitutes the nodular radiodensities on this patient's x-ray film?
A. Calcium Oxalate
B. Cholesterol
C. Conjugated bilirubin
D. Unconjugated bilirubin
E. Uric Acid
0 - ArchivalUser - 07-01-2012
excellent and it taught me a lot.. will write the explanation after
0 - ArchivalUser - 07-01-2012
Bbb
0 - ArchivalUser - 07-01-2012
Sammi does cholesterol show up on xray??? so it cant be b
0 - ArchivalUser - 07-01-2012
A. Calcium Oxalate
0 - ArchivalUser - 07-01-2012
A..
0 - ArchivalUser - 07-01-2012
no radiolucent cholesterol stone?
0 - ArchivalUser - 07-01-2012
PATHOMA people refer to page 117 on top for a clear explanation.
D. Bilirubin stones are composed of bilirubin
1. Usually radiopaque
2. Risk factor includes extravascular hemolysis(increases unconjugated bilirubin) and biliary tract infection (E.Coli, Ascaris, clonorchis)
In a patient presenting with RUQ pain, radio dense opacities on xray files, and lab values suggesting hemolytic anemia, pigmented stones made of unconjugated bilirubin should be suspected. Pigmented stons are radiopaqe on xray films unlike pure cholestrol stones which are radiolucent.- Answer is D unconjugated bilirubin
Not cholesterol because 10% they are radiopaque. 80% they are radiolucent. Given this patient's hemolytic anemia (fatigue etc) her cholelithasis is from pigment stones.
Not calcium oxetate because it's a form of kidney stones that are radiopaque but they do not form gallstones..
-EXCELLENT RX question
0 - ArchivalUser - 07-01-2012
@jdmed84
so why were u querying my choice of cholesterol stone?
thanx though
0 - ArchivalUser - 07-01-2012
Excellent job