Serum iron
The presence of a "golden ring" on the iris is often indicative of Kayser-Fleischer rings, which are associated with Wilson's disease. Wilson's disease is a genetic disorder that results in excessive copper accumulation in the body, specifically affecting the liver and brain. The golden or brownish ring around the cornea is formed due to copper deposition.
To diagnose Wilson's disease, the next appropriate investigation is to measure serum ceruloplasmin levels. Ceruloplasmin is a protein that binds copper for transportation in the bloodstream, and its levels are typically low in individuals with Wilson's disease.
Given the options:
Alpha-1-antitrypsin |
Alpha-fetoprotein |
Serum iron |
Serum ceruloplasmin |
The most suitable test to proceed with is measuring serum ceruloplasmin, as it is directly related to the suspected condition of Wilson's disease.
A patient presents with no pulse, and the ECG shows the following rhythm. What is the next appropriate step?
Identify the ulcer: