What is your diagnosis (4)?

Ngenge exam is very very near. Let’s have some fun with these GIT questions:

55 year old man presents with increased skin pigmentation, steatorrhea and diabetis mellitus. The mechanism most likely responsible for this constellation findings is:

  1. amyloidosis
  2. alcoholic cirrhosis
  3. a defect in iron metabolism
  4. alpha1-antitrypsin deficiency
  5. a defect in copper metabolism

 Answer: Hemochromatosis – metabolic liver disease in which the defect is in iron metabolism.


60 year old woman has conjugated bilirubin 57% of the total bilirubin. What is the most likely diagnosis?

Answer: cholestasis @ post-hepatic obstruction


And a bit about biochemistry:

A 35 years old Malaysian woman has a long history of explosive diarrhea and abdominal distension after eating dairy products. What is the pathogenesis of her diarrhea?

  1. antigliadin antibodies
  2. cAMP activation
  3. mucosal invasion
  4. intraluminal osmotically active solutes

Answer: This one is quite a killer question, no one got this right. Choice (1) is the pathogenesis of celiac disease, not the diarrhea. The next 3 choices below explain the pathogenesis of diarrhea.

  1. Secretory diarrhea – by vibrio cholera and enterotoxigenic E. Coli (ETEC) @ traveler’s diarrhea. Pathogenesis includes increasing in cAMP thus increasing secretion. This is choice no. 2.
  2. Invasive diarrhea – by Shigellosis and enteroinvasive E. Coli (EIEC). On fecal smear can see bloody diarrhea and pus. This is choice no.3.
  3. Osmotic diarrhea – due to lactase deficiency. The person is intolerant to lactose (dairy products). The blunting of villi in this person’s intestinal mucosa leads to malabsorption of dairy products -> intraluminal hyperosmosis. The correct answer is choice no. 4.

Congratulations for trying to answer! The winner is – the boss! Ngenge…


4 thoughts on “What is your diagnosis (4)?

  1. Salam Faiz

    All the best, I will give you a return ticket if you can answer all!
    All the best for the next 2 exams.


  2. heh.. never trust faiz with watever he claimed to give :P. im keeping the answers to myself till i get my spaghetti treat! ngengenge~

  3. yay! jatdin got it all correct even for the last Qs eventho she didnt post the answers due to faiz’s fake giveaway prizes! (mind u, im the one correcting ur ‘errors’ for the last qs! :P). haha! tpaksa treat myself spaghetti of my own.. nk tggu faiz blanja, kena tggu mama die sound die supaya blanja jatdin cpt2! haha!~

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