welcome redditors!to snoo-finity ... and beyond!

NBME 23 Answers

nbme23/Block 2/Question#44

A 4-year-old boy is brought to the physician by his ...

Dietary change

Login to comment/vote.

 +15  upvote downvote
submitted by welpdedelp(137),

No diet deficiency, the patient had excess carotene due to his diet

sympathetikey  Would never have thought of that. Thanks +5  
medschul  that's messed up dog +11  
hpkrazydesi  Excess carotene in what way? sorry if thats a stupid question +  
davidw  this is directly from Goljan "Dietary β-carotenes and retinol esters are sources of retinol. β-carotenes are converted into retinol. (a) Increased β-carotenes in the diet cause the skin to turn yellow (hypercarotenemia). Sclera remains white, whereas in jaundice the sclera is yellow, which can be used to distinguish the two conditions. (c) Vitamin toxicity does not occur with an increase in serum carotene" +4  
davidw  β-Carotenes are present in dark-green and yellow vegetables. +  
hyperfukus  ohhhh hellllll no +3  
dashou19  When I was a little kid, I like to eat oranges, like I could eat 10 oranges at once, and after a few days, I could tell that I turned yellow... +5  

There's an episode in scrubs the person is orange i looked up "too much carrot" they look orange NBME language strikes again

+7/- ergogenic22(121),

 +14  upvote downvote
submitted by water(20),

surprisingly, I actually learned this from the Magic School Bus when I was a kid. That's the only reason I got this right. Thanks Ms. Frizzle! :D

paulkarr  She taught me more than my med school professors did... +4  

I actually think he might have iron-deficiency anemia that can be described as pallor or "yellowing of the skin." He does not have jaundice (anicteric sclera) Patients who are strict vegans can develop iron deficiency. The best way to correct this is to encourage a dietary change

 +0  upvote downvote
submitted by alexb(31),

I guess he's taking B12 supplements, otherwise he would have a symptomatic deficiency, right?