A 28-year-old woman presents with complaints of intermittent abdominal distension and bloating. She experiences bouts of loose motions that provide relief from the symptoms. There is no history of rectal bleeding or weight loss. The patient works as a manager in a busy office and finds work to be stressful. She has previously taken a course of fluoxetine for depression/anxiety. Abdominal examination is unremarkable.
What is the probable diagnosis?
A 55-year-old man presents to the clinic with abnormal liver function tests (LFTs). He reports drinking no more than 3 units of alcohol per week and has no significant medical history. The patient was prescribed amoxicillin by his primary care physician for a sinus infection two weeks ago.
During the physical examination, the patient’s BMI is found to be 40 kg/m2, indicating obesity. The LFTs reveal:
– ALT 120 U/L (5-40)
– AST 130 U/L (10-40)
– Alkaline phosphatase 200 U/L (45-105)
What is the most likely cause of this liver function test derangement?
A 61-year-old man has been admitted to a General Surgical Ward, following an endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis. The procedure took place approximately two hours ago and went well, without complications. The patient is now complaining of central abdominal pain, radiating to the back.
His observations are normal. Examination is significant for central abdominal pain. His blood tests are significant for an amylase level of 814 u/l. His pre-ERCP amylase level was 89 u/l.
What is the most likely diagnosis?
A middle-aged woman presented to her General Practitioner (GP) with a 3-month history of epigastric pain and weight loss. She mentions that she tried over-the-counter antacids which provided some relief initially, but the pain has got worse. She decided to see her GP after realising she had lost about 5 kg. She denies any vomiting or loose stools. She has never had problems with her stomach before and she has no significant family history. Endoscopy and biopsy are performed; histology shows active inflammation.
What is the most likely diagnosis?
A 55-year-old man, with a 25-pack-year history of smoking, presents to his General Practitioner with a 3-month history of epigastric pain. He has been unable to mow his lawn since the pain began and is often woken up at night. He finds that the pain is relieved by taking antacids. He has also had to cut back on his spicy food intake.
What is the most probable reason for this man’s epigastric pain?
A 72-year-old man comes in with complaints of gradual difficulty swallowing and noticeable weight loss. Upon endoscopy, a tumour is discovered in the lower third of his oesophagus. Which of the following ailments is commonly linked to oesophageal adenocarcinoma?
A middle-aged woman has presented to her GP with bowel symptoms, specifically wind and bloating. After conducting several tests, the GP has diagnosed her with irritable bowel syndrome (IBS).
What is an appropriate dietary recommendation to provide to this middle-aged woman?
A 25-year-old man presents with mild jaundice following a flu-like illness. During a review by a gastroenterologist, he has been told that a diagnosis of Gilbert’s syndrome is probable.
Which of the following test results most suggests this diagnosis?
A 38-year-old woman is experiencing gradual onset of epigastric pain that worsens during and after meals. The pain began about a month ago and is moderate in intensity, without radiation to the back. Occasionally, the pain is severe enough to wake her up at night. She reports no regurgitation, dysphagia, or weight loss. Abdominal palpation reveals no tenderness, and there are no signs of lymphadenopathy. A negative stool guaiac test is noted.
What is the most likely cause of the patient’s symptoms?
A 68-year-old man presents to the Emergency Department with hypotension and maelena despite receiving 6 units of blood. He has a medical history of arthritis and takes methotrexate and ibuprofen. What is the next most appropriate course of action from the following options?