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  1. #1
    BioPatel is offline Member
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    sickle cell anemia

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    A 25-year-old woman with sickle cell anemia complains of steady pain in her right upper quadrant with radiation to the right shoulder, especially after large or fatty meals. Her physician diagnoses gallstones. Of which of the following compounds are these stones most likely composed?

    A. Calcium bilirubinate
    B. Calcium oxalate
    C. Cholesterol
    D. Cholesterol and calcium bilirubinate
    E. Cystine

  2. #2
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    Asclepius1 is offline Ultimate Member 537 points
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    B.

  3. #3
    OLM
    OLM is offline Newbie
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    My guess is calcium bilirubinate because sickle celll causes hemolysis and release of bili to form stone

  4. #4
    BioPatel is offline Member
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    The correct answer is A. Bilirubin is a degradative product of hemoglobin metabolism. Bilirubin (pigment) stones are specifically associated with excessive bilirubin production in hemolytic anemias, including sickle cell anemia. Bilirubin stones can also be seen in hepatic cirrhosis and liver fluke infestation.
    Calcium oxalate stones (choice B) and cystine stones (choice E) are found in the kidney, rather than the gallbladder.

    Pure cholesterol stones (choice C) are less common than mixed gallstones, but have the same risk factors, including obesity and multiple pregnancies.

    Mixed stones (choice D) are the common "garden variety" gallstones, found especially in obese, middle aged patients, with a female predominance.

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