A 68-year-old man with atrial fibrillation (AF) visits the Emergency Room (ER) with complaints of intense abdominal pain that has been ongoing for the past two hours. His arterial blood gas results reveal metabolic acidosis with elevated lactate levels.
What is the most probable diagnosis from the options below?
A 32-year-old woman with a 9-month history of weight loss, intermittent bloody mucus stools and abdominal pain undergoes a colonoscopy, which shows a mucosal ‘cobblestone’ pattern and skip lesions. She drinks approximately four units of alcohol a week and has a smoking history of five pack years.
Which of the following is the most appropriate lifestyle advice for this patient?
A 58-year-old man has been experiencing recurrent epigastric pain for several years. His symptoms improved with a proton pump inhibitor (PPI) but returned after discontinuing the medication. He tested positive for Helicobacter pylori, but his symptoms returned after receiving eradication therapy. He now has unexplained iron deficiency anemia. What is the most appropriate next step in management?
A 45-year-old woman presents to the clinic with a three-week history of heartburn. There is no significant weight loss, no alteration in bowel movements, no nausea, and no difficulty swallowing. Physical examination reveals no abnormalities.
What is the most appropriate course of action?
A 42-year-old-woman, who rarely visits the clinic, complains of heartburn and acid reflux for the past 3 weeks. She comes back after taking a PPI for 1 week with some relief. Her BMI is 27 kg/m2. What is the most suitable next step in her treatment?
A 42-year-old man with a 4-week history of a diagnosed anal fissure returns to the general practice surgery for review. He has been regularly using stool softeners along with eating a healthy diet and drinking adequate water. He is still experiencing bleeding and pain on opening his bowels. Examination reveals an anal fissure with no alarming signs.
Which of the following would be the most appropriate management at this stage?
A 60-year-old man who was recently diagnosed with chronic pancreatitis presents to his General Practitioner due to persistent central abdominal pain. This has been present ever since he was admitted to the hospital and diagnosed with chronic pancreatitis; however, he feels that the medication he was prescribed is losing its effects.
The patient is currently on amlodipine, amitriptyline, perindopril and pancreatic enzyme replacement.
Which of the following management options is the best next step to control the patient’s pain?
Select the SINGLE best management plan from the list below.
Select ONE option only.
A 42-year-old woman presents to the Emergency Department with retrosternal chest pain. She is admitted and all cardiac investigations are normal. She is diagnosed with gastro-oesophageal reflux disease.
Which of the following symptoms would most commonly require an urgent inpatient upper gastrointestinal (GI) endoscopy before being discharged?
A 50-year-old woman was urgently referred for investigation (2-week wait) via the cancer referral pathway by her General Practitioner after presenting with a 2-month history of weight loss and fatigue. Blood tests reveal a carcinoembryonic antigen (CEA) level of 300 μg/l (Normal range: 2.5–5.0 μg/l).
Which of the following is the most probable diagnosis?
A 42-year-old man with irritable bowel syndrome (IBS) is struggling to manage his symptoms through dietary changes alone. He is primarily bothered by abdominal discomfort and bloating.
What is the most suitable next step in his treatment plan?