A chronic alcoholic stumbles into your emergency room, but as you take a history, you realize he has no idea who he is or where he is. He can't do serial 7's, doesn't remember any of three objects after a few minutes, can't copy a figure. His MMSE is pretty bad. On exam, you notice this:

Challenge 1: Is it something he ate? Or something he didn't eat? What's the diagnosis?
-

Challenge 2: What's the mutated gene?
First image is in the public domain, second image shown under fair use.
2 comments:
d words:
drunk?
diuretic?
wernicke's encephalopathy does not begin with a d!
duchenne muscular dystrophy
Dubious D’s
The first case is characterized by 3D’s: dermatitis, dementia, diarrhea. This is pellagra, vitamin B3 (niacin) deficiency.
The second case is Duchenne muscular dystrophy, a mutation in dystrophin.
Source: First Aid, Wikipedia, iris.peabody.vanderbilt.edu.
Post a Comment