Monday, May 19, 2008

When All You Have is a Hammer, Everything Looks Like

A 40 year old woman recently diagnosed with celiac disease presents with fatigue. She says that she can only walk a few blocks or flights of stairs before she gets tired. She can't recall a specific incident that brought this on; now that she thinks about it, it's been going on for a while. Past medical history is remarkable only for the celiac disease. There is no pertinent family history. She has had three kids. On exam, everything seems within normal limits except for the finding shown below.

Challenge: What's the diagnosis?

Image is in the public domain.

1 comment:

Craig said...

When All You Have is a Hammer, Everything Looks Like

The “classic” presentation of iron deficiency anemia is a multigravid woman in her 40s presenting with tiredness, fatigue, and chronic blood loss from menometrorrhagia with a microcytic anemia. The image shows the unique finding of koilonychias or spoon nails. Celiac disease is one cause of iron deficiency anemia.

Source: UpToDate;