Answer

If you find the material on this website useful, you will find that the two books ACES for PACES and KEYS to SUCCESS in Medicine complement the material on these sites and will enhance your studying and revision

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ACES for PACES

Medical Revision

Clinical Skills Blogspot

BOF: 53

A 50-year-old man presents with malaise, weight loss, diarrhoea and pain in the joints. He is pigmented, has clubbing and lymphadenopathy. He has ascites and ophthalmoplegia. Investigations show him to be anaemic. ECG shows a right bundle branch block and paracentesis abdominis reveals chylous ascites.

The investigation most likely to give a diagnosis would be:

a)      Lumbar puncture

b)      CT head

c)      Ascitic fluid cytology

d)      Small bowel biopsy

e)      Transoesophageal echocardiography

Answer:

d)

The patient has Whipple’s disease, which is diagnosed by the demonstration of multiple macrophages in the lamina propria and the presence of rod shaped bacteria both within and without the abnormal macrophages.

Revision Tip

Revise Whipple's disease KEYS to SUCCESS in Medicine page 246-247

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