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A physician from the United States decides to take a sabbatical from his responsibilities at a teaching
hospital to
work in a clinic in a remote part of Africa. During his first week at the clinic, he is told that he will be
seeing a
patient with glucose-6-phosphate dehydrogenase deficiency. Which of the following will be the most
likely clinical
presentation of this patient?
A. A 6-month-old child who develops severe anemia following a respiratory tract infection
B. A child who develops hemoglobinuria following a meal of beans
C. A neonate with an enlarged spleen and severe anemia
D. An adult who develops anemia following use of antimalarial drugs
E. An adult who develops severe shortness of breath during an airplane ride
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D is correct...but the option B which states meal of beans cud also be a possibility as fava beans ingestion also lead to G6PD....ANY VIEWS on the option b..? aim high..
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i saw this q before and i can remember it coz.my answer was d but i got astonished when i found the answer was wrong and it`s b BEANS although i think malaria is a more dominant cause coz.it`s in africa
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i think the answer is B cos the patient first presentation would be as a child and not as an adult who took antimalaria drugs and since it is africa malaria is endemic and that would not have been the first time the patient would be taking anti malaria drugs, but as a child who took beans most likely fava beans ,he would present with hemoglobinuria and that would be more disturbing for the parents so they would bring him to see the doctor.
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i agree with omni as adult with first presentation of malaria wud not be possible considering the prevalence of malaria in africa...it wud have been right if it was child with antimalarial drugs ...
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grave mistake of mine extrenly sorry guys
The correct answer is B. In Africa, the classic presentation of glucose-6-phosphate dehydrogenase
deficiency is
a child who eats a meal of beans (Vicia fava) and several hours later develops hemoglobinuria and
peripheral
vascular collapse secondary to intravascular hemolysis as a result of the oxidant injury initiated by the
fava
beans. Blood studies in this setting show a rapid fall in total hemoglobin and a rise in free plasma
hemoglobin,
accompanied by a rise in unconjugated bilirubin and a fall in haptoglobin. The episode usually
resolves spontaneously several days later. Today, the classic presentation is less common in developed
countries than
is a slower onset syndrome beginning 1-3 days after starting an antimalarial drug, sulfonamide, or
other
antioxidant drug. Rarely, glucose-6-phosphate dehydrogenase deficiency presents as neonatal
jaundice or with
chronic hemolysis.
