A 56-year-old patient with a history of alcoholism is admitted to the emergency department after experiencing acute haematemesis. During emergency endoscopy, bleeding oesophageal varices are discovered and treated with banding. The patient’s hospital stay is uneventful, and they are ready for discharge after 10 days. What medication would be the most appropriate prophylactic agent to prevent the patient from experiencing further variceal bleeding?
A 40-year-old man has been admitted after a severe paracetamol overdose. Despite medical intervention, he has developed liver failure. What is the most probable outcome of the liver failure?
A 50-year-old obese woman presents to the Emergency Department (ED) with increasing shortness of breath and right-sided chest pain over the past few days. She appears unwell and has a temperature of 38.9°C. On room air, her oxygen saturations are 85%, and her blood pressure is 70/40 mmHg with a heart rate of 130 beats per minute in sinus rhythm. A chest X-ray (CXR) reveals consolidation in the right lower lobe, and her blood tests show bilirubin levels of 120 µmol/litre and ALP levels of 300 IU/litre. She also experiences tenderness in the right upper quadrant.
What additional investigation would you perform to confirm the diagnosis?
A 25-year-old man comes back from a visit to India with symptoms of nausea, anorexia, and fatigue. During a physical examination, his doctor observes clinical jaundice and moderate palpable liver and spleen. After conducting blood tests and viral markers, the diagnosis is hepatitis A. What is the mode of transmission for hepatitis A?
A 35-year-old female who is post-partum and on the oral contraceptive pill, presents with right upper quadrant pain, nausea and vomiting, hepatosplenomegaly and ascites.
What is the most probable reason for these symptoms?
A 50-year-old man with a history of chronic active hepatitis B presents with abdominal distension and bilateral ankle oedema, worsening over the previous 2 weeks. Three months ago, he was admitted for bleeding oesophageal varices, which was treated endoscopically. There was shifting dullness without tenderness on abdominal examination, and splenomegaly was also noted. His serum albumin concentration was diminished. Prothrombin time was elevated.
Which one of the following diuretics will best help this patient?
A 35-year-old man with a family history of colorectal cancer presents for genetic screening. Genetic testing is performed and he is diagnosed with hereditary non-polyposis colorectal cancer syndrome (HNPCC, or Lynch syndrome).
What is his lifetime risk for developing colorectal cancer?
A 50-year-old man visited his doctor as his son has expressed concern about his alcohol consumption. He admits to drinking two bottles of wine (750ml capacity) every night along with six pints of 5% beer.
(A bottle of wine typically contains 12% alcohol)
What is the total number of units this man is consuming per night?
For which of the following conditions is urgent referral for upper endoscopy necessary?
A 52-year-old male construction worker has been admitted with haematemesis and is scheduled for an urgent upper GI endoscopy. According to the Rockall score, which feature would classify him as being in the high-risk category for a patient presenting with GI bleeding?