A 40-year-old woman presents to the Gastroenterology Clinic for a follow-up appointment after a liver biopsy. She was referred by her General Practitioner two weeks ago due to symptoms of fatigue, myalgia, abdominal bloating and significantly abnormal aminotransferases. The results of her liver biopsy and blood tests confirm a diagnosis of autoimmune hepatitis (AIH).
What should be the next course of action in managing this patient?
A 38-year-old woman has chronic pancreatitis. She has lost weight and has troublesome diarrhoea. She reports that she has had diarrhoea daily and it has a strong, malodorous smell. The unintentional weight loss is 7 kg over the last year and she has had a general decrease in energy.
Which preparation would be most suitable to decrease her diarrhoea?
A 26-year-old baker visits his GP with concerns about yellowing sclera that have developed over the past week. He has no significant medical history except for a recent viral infection that he has since recovered from. He drinks socially, consuming approximately 20 units per week, and has been in a four-year relationship with his girlfriend. His aunt’s death from complications of Wilson’s disease is a cause for concern, as her eyes also turned yellow before she became seriously ill. What is the most frequently linked outcome with Wilson’s disease?
A 50-year-old man with a prolonged history of alcohol abuse complains of fatigue and general discomfort. Upon examination, his liver function tests are abnormal, and he is referred to a specialist who diagnoses him with alcohol-related cirrhosis. What is the main pathophysiological mechanism involved in alcoholic cirrhosis?
A 28-year-old woman is admitted after a paracetamol overdose. She took 25 500-mg tablets 6 hours ago. This is her first overdose. She has a history of anorexia nervosa and is severely malnourished, weighing only 42 kg. She has a past medical history of asthma, for which she uses a long-acting corticosteroid inhaler. She also takes citalopram 20 mg once daily for depression. What factor increases her risk of hepatotoxicity after a paracetamol overdose?
A 38-year-old man is referred by his general practitioner due to experiencing epigastric pain. The pain occurs approximately 3 hours after eating a meal. Despite using both histamine 2 receptor blockers and proton pump inhibitors (PPIs), he has only experienced moderate relief and tests negative on a urease breath test. An endoscopy is performed, revealing multiple duodenal ulcers. The patient’s gastrin level is tested and found to be above normal. A computed tomography (CT) scan is ordered, and the patient is diagnosed with Zollinger-Ellison syndrome. Which hormone typically inhibits gastrin secretion?
A 55-year-old woman presents to her General Practitioner (GP) after her friends told her that her skin and eyes have become yellow. She says that she has noticed this too, but over the past month it has become worse. Her clothes have become loose lately. Her past medical history includes type II diabetes mellitus, hypertension, dyslipidaemia and chronic obstructive pulmonary disease (COPD).
She has a 30-pack-year smoking history and consumes approximately 30 units of alcohol per week. In the past, the patient has had repeated admissions to the hospital for episodes of pancreatitis and she mentions that the surgeon explained to her that her pancreas has become scarred from these repeated episodes and is likely to cause her ongoing abdominal pain.
Which of the following is a risk factor for this patient’s most likely diagnosis?
A 40-year-old woman presents with sudden upper abdominal pain and loss of appetite. Upon examination, she has enlarged liver, abdominal distension, and swelling in both legs. Notably, there are visible veins on her back that flow upwards. What is the most probable underlying factor for this condition?
Which of these options does NOT contribute to abdominal swelling?
A 36-year-old man complained of abdominal pain and weight loss. Upon investigation, he was diagnosed with coeliac disease. The biopsy of his small intestine revealed blunting of villi with crypt hyperplasia and intraepithelial lymphocytes ++. What is the stage of his disease?