WBR1008

Author	[[PageAuthor::Vidit Bhargava, M.B.B.S [1]]]
Exam Type	USMLE Step 2 CK
Main Category	Internal medicine
Sub Category	Dermatology
Prompt	[[Prompt::A 42 years old female presents to her physician with following complaints: Abdominal pain which is severe and poorly localized since last 2 weeks, dark urine, altered sensation, sweating, restlessness and tremor, anxiety, agitation. She has also been hearing voices on and off which, tell her to harm her neighbor. She also experiences bouts of sudden uncontrolled weeping. On physical examination she has raised heart beat and slightly elevated blood pressure, but is otherwise unremarkable. After doing a thorough work up, she is diagnosed with a defect in heme metabolism. Which of these correctly represents her disease and the enzyme defect that she is suffering from? Shown below is an image depicting the heme metabolism: ]]
Answer A	Acute intermittent porphyria; porphobilinogen deaminase
Answer A Explanation
Answer B	Congenital erythropoietic porphyria; uroporphyrinogen III synthase
Answer B Explanation
Answer C	Variegate porphyria; protoporphyrinogen oxidase
Answer C Explanation
Answer D	Acute porphyria; ALA synthase deficiency
Answer D Explanation
Answer E	Acute porphyria; ALA dehydrogenase deficiency
Answer E Explanation
Right Answer	A
Explanation	Educational Objective: References:
Approved	No
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