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

NBME 24 Answers

nbme24/Block 4/Question#5

A 45-year-old man comes to the physician because of ...

Muscle biopsy

Login to comment/vote.

 +8  upvote downvote
submitted by sattanki(31),

Muscle pain + periorbital edema is a classic presentation for trichonella spiralis. Best diagnosis for this is a muscle biopsy, as the wormy likes to hangout within the muscles.

sympathetikey  That's what you get for killing polar bears. +13  
dr.xx  That's what you get for not cooking them well. +1  
charcot_bouchard  Theres nothing called "well cooked polar bear meat" +1  




 +5  upvote downvote
submitted by neonem(262),

Apparently trichinella lies around in muscle of all of the random exotic animals that most people wouldn't normally eat... things like bear, wild boars/pork (like in Sketchy Micro), big cats, foxes, dogs, horses, seals, walruses. In case you needed another reason to not hunt and consume these animals?



how to rule out the others:

we would see eosinophilia, but obvi this wouldnt tell us which helminth is involved

Trichinella larvae bury themselves inside muscle tissue rather than remain in the intestine as in other roundworm infections, so stool sample tests don't often show evidence of the parasite

gram stain of stool is a pretty nonspecific test used for campylobacter enteritis; this dude doesnt have diarrhea xray of muscle aint gonna tell u a thang lolz

+/- sunshinesweetheart(5),

how to rule out the others:

we would see eosinophilia, but obvi this wouldnt tell us which helminth is involved

Trichinella larvae bury themselves inside muscle tissue rather than remain in the intestine as in other roundworm infections, so stool sample tests don't often show evidence of the parasite

gram stain of stool is a pretty nonspecific test used for campylobacter enteritis; this dude doesnt have diarrhea...and lastly, xray of muscle aint gonna tell u a thang lolz

+1/- sunshinesweetheart(5),


 +0  upvote downvote
submitted by jucapami(0),

https://www.cdc.gov/parasites/trichinellosis/biology.html worth taking a look.