Internal Medicine Solution 7

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PNH and the GPI-Linked ProteinsOption C

Screening may be performed with a urine dipstick test. The orthotoluidine portion of the dipstick turns blue in the presence of hemoglobin or myoglobin. Positive urine "blood" can be used as a surrogate marker for myoglobin if freshly spun sediment of urine shows no red blood cells. In this setting, a serum sample with normal color indicates myoglobinuria, whereas a pigmented brown or red serum sample indicates hemoglobinuria.

Diagnosis:
Urine dipstick- useful for screening; orthotoludine part turns blue in presence of hemoglobin or myoglobin
Urine or serum test for myoglobin
CK elevated 5x normal
Increased AST, ALT, LDH
Increased BUN and Cr due to renal failure
Decreased calcium, increased K, urate, WBC, and high anion gap acidosis




Category: Medicine MCQs

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