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NBME 22 Answers

nbme22/Block 1/Question#28 (26.8 difficulty score)
A 48-year-old man comes to the physician ...
Transferrin saturation and serum ferritin measurementsπŸ”

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submitted by lamhtu(86),
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meHcmrstasoohio osatsicdea thwi AHA-,L3 utb eth itprapaerpo snenrcige test si musre annseirrrft toanustari and treirifn ellevs

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submitted by keycompany(264),
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ehiWl hits isoquetn setm si veag,u eht omts leylik gidsasnio si eaHdrirety thamcrososeiomH.

Iron accumulation causes free radical damage in organs:

  • liver β†’ dysfunction / ascites / cirrhosis
  • pancreas β†’ glucose intolerance (diabetes)
  • heart β†’ cardiac enlargement (LVF can leads to prominent pulmonary vasculature)

Also notice patient + older brother are >40, which is when total iron body accumulates enough to cause symptoms.

Hemochromatosis (Auto Recessive HFE Gene on Ch.6) Labs :

↑↑ Serum Iron & Ferritin & Transferrin saturation