A 38-year-old man complains of dyspepsia without any alarm symptoms. He has no significant medical history and this is his first episode. The plan is to use a test-and-treat approach. What is the most suitable test to detect Helicobacter pylori?
An 82-year-old man arrives at the emergency department with haematemesis that began 45 minutes ago. He has a history of chronic back pain and takes ibuprofen, as well as warfarin for his atrial fibrillation. The medical team initiates resuscitation and places two large-bore cannulas. What is the appropriate management for this patient in an acute setting?
A 50-year-old man who takes omeprazole 20 mg for gastroesophageal reflux disease has reported a recent worsening of his indigestion and an unintentional weight loss of 5kg over the past 2 months. He has been referred for a 2-week wait and scheduled for an endoscopy in 3 weeks. What guidance should he receive regarding his omeprazole usage?
How many units of alcohol are in a 750ml bottle of red wine with an alcohol by volume of 12%?
A 57-year-old patient visits the GP clinic complaining of painful burning sensations in her chest for the past week, particularly after eating. She also mentions feeling bloated, which is a new experience for her. During the examination, the GP observes some abdominal tenderness and decides to order an upper GI endoscopy. The patient is currently taking aspirin, metformin, and omeprazole. What guidance should the GP offer her regarding the procedure?
A 50-year-old woman with a history of alcoholic liver disease presents to the clinic with advanced cirrhosis and ascites. A recent ascitic tap revealed a protein concentration of 12 g/L and no evidence of organisms. What is the best course of action to manage the risk of spontaneous bacterial peritonitis?
A 35-year-old female patient complains of indigestion for the past three months. She denies any weight loss, anorexia, dysphagia, vomiting, or alteration in bowel habits. Her abdominal examination is normal. What factor could potentially reduce the reliability of a 13C-urea breath test?
As the medical doctor on call, a 23-year-old woman presents to the emergency department with a 4-day history of loose stools, abdominal pain, and fatigue. She reports having bowel movements an average of 8 times a day, and in the last 24 hours, she has noticed blood mixed in with the stools. The patient has a medical history of ulcerative colitis, which is typically well controlled with rectal mesalazine. She has no allergies or other medical conditions.
Upon examination, the patient’s blood pressure is 100/60 mmHg, heart rate is 95 beats per minute, respiratory rate is 16/min, oxygen saturation is 96%, and temperature is 37.9 ºC. Heart sounds are normal, chest is clear, and the abdomen is soft with localized tenderness in the left iliac fossa. There is no guarding or peritonism, and bowel sounds are audible.
The patient’s Hb is 102 g/L (normal range for females: 115-160), platelets are 398 * 109/L (normal range: 150-400), WBC is 13.2 * 109/L (normal range: 4.0-11.0), Na is 140 mmol/L (normal range: 135-145), K is 3.8 mmol/L (normal range: 3.5-5.0), urea is 4.6 mmol/L (normal range: 2.0-7.0), creatinine is 95 µmol/L (normal range: 55-120), and CRP is 35 mg/L (normal range: <5). Based on these findings, a flare of ulcerative colitis is suspected. What is the appropriate management plan for this patient?
A 35-year-old man with ulcerative colitis is seen for his follow-up appointment. He had a moderate flare-up of his condition two months ago, which was treated with oral steroids and resolved. He has not had any other flare-ups in the past year and his most recent colonoscopy showed left-sided disease. He is currently asymptomatic, with normal observations and bowel movements of 2-3 times per day. What is the best medical treatment to maintain remission for this patient?
A 50-year-old man presents to the emergency department with right upper quadrant pain, fatigue, and anorexia that has been going on for a few weeks and is getting gradually worse. His past medical history includes heavy alcohol intake, gastroesophageal reflux disease (GORD) and a hiatus hernia. He only takes omeprazole and has no known allergies.
On examination, he looks jaundiced.
A liver function test is done which shows:
Bilirubin 50 µmol/L (3 – 17)
ALT 150 u/L (3 – 40)
AST 300 u/L (8 – 33)
Albumin 35 g/L (35 – 50)
What is the most likely diagnosis?