A 50-year-old known alcoholic presents to the Emergency Department with disorientation. Upon examination, there is gross distension of the abdomen, shifting dullness, pitting edema to the mid-thigh, and a temperature of 38ºC. What is the probable diagnosis?
A 38-year-old woman complains of itching and yellowing of the skin.
Blood tests reveal:
Bilirubin 45 µmol/L (3 – 17)
ALP 326 u/L (30 – 100)
ALT 72 u/L (3 – 40)
Positive anti-mitochondrial antibodies.
What is the probable diagnosis?
A 52-year-old woman presents with lethargy and pruritus. She reports having a normal appetite and no weight loss. Upon examination, there is no clinical jaundice or organomegaly. The following blood test results are obtained:
– Hb: 12.8 g/dl
– Platelets: 188 * 109/l
– WBC: 6.7 * 109/l
– Na+: 140 mmol/l
– K+: 3.9 mmol/l
– Urea: 6.2 mmol/l
– Creatinine: 68 µmol/l
– Bilirubin: 30 µmol/l
– ALP: 231 u/l
– ALT: 38 u/l
– γGT: 367 u/l
– Albumin: 39 g/l
What additional test is most likely to lead to a diagnosis?
Which of the following extra-intestinal symptoms of inflammatory bowel disease is more prevalent in ulcerative colitis than in Crohn’s disease, with a slight variation in age and maintaining paragraph breaks?
A 54-year-old man with a history of alcoholic liver disease and cirrhosis is scheduled for an oesophago-gastro-duodenoscopy (OGD) to screen for oesophageal varices. The OGD reveals several high-risk varices, and medical prophylaxis is advised. What medication would be the best choice?
Which of the following is a common feature of ulcerative colitis?
A 50-year-old woman visits your clinic to inquire about the safety of taking multivitamin supplements. She confesses that she has been consuming high doses of vitamin B6 supplements, believing that it would alleviate her anemia and boost her energy levels. She seeks your advice on whether she should continue taking the supplements.
What is a potential adverse effect of excessive intake of vitamin B6 (pyridoxine)?
A 63-year-old woman with a history of scleroderma presents with recurrent bouts of diarrhoea for the past few months. Her stools are pale, bulky, and offensive during these episodes. She consumes 12 units of alcohol per week. Laboratory tests reveal the following results:
– Hemoglobin: 10.8 g/dL
– Platelets: 231 * 10^9/L
– White blood cells: 5.4 * 10^9/L
– Ferritin: 14 ng/mL
– Vitamin B12: 170 ng/L
– Folate: 2.2 nmol/L
– Sodium: 142 mmol/L
– Potassium: 3.4 mmol/L
– Urea: 4.5 mmol/L
– Creatinine: 77 µmol/L
– Bilirubin: 21 µmol/L
– Alkaline phosphatase: 88 U/L
– Alanine transaminase: 21 U/L
– Gamma-glutamyl transferase: 55 U/L
– Albumin: 36 g/L
What is the most likely complication that has occurred in this patient?
A 50-year-old man presents to his primary care physician with complaints of abdominal pain, bloating, and loose stools. He recently started a new medication after being hospitalized for an upper gastrointestinal bleed and spontaneous bacterial peritonitis. Despite not reporting any blood loss, he has noticed a gradual worsening of his symptoms since his hospital discharge. The patient has a medical history of gout, type-2 diabetes, hypertension, alcoholism, and ischaemic heart disease. He quit smoking 10 years ago. Which medication is the most likely culprit for his symptoms?
A 26-year-old male complains of epigastric pain and reflux that worsens after eating. He underwent first-line triple-therapy eradication treatment for a positive Helicobacter pylori stool antigen test 3 months ago, which initially relieved his symptoms. However, they have now returned, and he wishes to undergo re-testing. What is the most suitable test to arrange?