A 36-year-old woman visits her doctor complaining of fatigue and itchy skin. During the examination, the doctor notices yellowing of the eyes and an enlarged liver. Blood tests reveal the presence of anti-mitochondrial antibodies (AMAs).
What is the most probable diagnosis? Choose ONE answer from the options below.
A 60-year-old woman presents to her General Practitioner with mild central abdominal discomfort. She also reports unintentional weight loss over the past four months. However, she denies any rectal bleeding or fatigue and has no significant family history.
What is the most appropriate course of action for management?
A 45-year-old woman presents to the Emergency Department with a 2-month history of dull abdominal pain. It is central and occasionally radiates to her back. However, this is not always present and it seems to get worse half an hour after a meal. She denies any vomiting or diarrhoea but confirms that painful episodes are accompanied by nausea.
The patient does not have any past medical history but admits that she has been drinking a glass of wine every night for the past 15 years. An abdominal X-ray is done.
Given the likely diagnosis, which of the following findings are most likely to be seen on the abdominal X-ray?
Select the SINGLE most likely finding from the list below.
A 62-year-old woman comes to the Emergency Department with acute abdominal pain. She is experiencing severe pain in the epigastric region that radiates to her back and is vomiting excessively. When questioned, she confesses to having had too many drinks at a bachelorette party the night before. Her serum amylase level is 1190 u/l. What is the most suitable initial management step?
Crohn’s disease is characterized by which of the following features? Please select the ONE most characteristic feature from the list provided.
A General Practice is conducting an audit on the number of elderly patients with gastrointestinal symptoms who were referred for endoscopy without a clear clinical indication.
Which of the following intestinal diseases necessitates blood tests and small intestinal biopsy for a precise diagnosis?
A 30-year-old woman presents with chronic diarrhoea. She says that her stools float and are difficult to flush away.
Investigations reveal the following:
Investigation Result Normal value
Potassium (K+) 3.1 mmol/l 3.5–5.0 mmol/l
Corrected calcium (Ca2+) 2.08 mmol/l 2.20–2.60 mmol/l
Albumin 29 g/l 35–55 g/l
Haemoglobin (Hb) 91 g/l 115–155 g/l
Mean corpuscular volume (MCV) 89 fl 76–98 fl
Coeliac disease is suspected.
Which of the following is the initial investigation of choice?
Which one of the following pathological changes favours ulcerative colitis (UC) over Crohn disease in elderly patients?
A 35-year-old man presents to the Emergency Department with rapid onset abdominal pain, which is worse on lying. He feels nauseous and is vomiting.
On examination, he is tachycardic and pyrexial at 38.1°C. His abdomen is tender with marked guarding. There is bruising around his umbilicus.
The patient reports drinking six cans of strong lager per day. He also smokes two packets of cigarettes a day. He says he was last in hospital two years ago when he was vomiting blood. He cannot remember what treatment he was given. He has no other medical history of note. He does not take any medications regularly.
What is the most likely cause for the man’s presentation and signs?
A 59-year-old man with known cirrhosis secondary to hepatitis C infection attends for review. There is a past history of intravenous heroin abuse and alcoholism. He has been feeling progressively more unwell over the past six months, with weight loss and worsening ascites. He is on long-term sick leave and has been closely monitored by his live-in partner, who maintains that there has been no further drug abuse or consumption of alcohol.
What is the most probable diagnosis based on this clinical presentation?