GIT and Hepatology Exam. Time 12 minute. Total Marks - 10

A 64-year-old female with a history of COPD and hypertension presents with pain on swallowing. Current medication includes a salbutamol and becotide inhaler, bendrofluazide and amlodipine. What is the most likely cause of the presentation?

A patient is post ERCP and develops severe epigastric pain. Given the likely diagnosis, how would you manage this patient?

A 68-year-old woman returns for her third visit in 3 months to casualty, complaining of extremely bad, dull epigastric pain radiating to her back. Her haemoglobin is 10.4 g/dl and her alkaline phosphatase is elevated. Which is the most appropriate management plan?

A 45-year-old woman with ulcerative colitis is admitted with a history of jaundice, pruritus and intermittent abdominal pain. Examination shows hepatosplenomegaly and mild ascites. Blood tests confirm an obstructive jaundice, and mitochondrial antibodies are not detected. What is the most likely diagnosis?

A 57-year-old man who has undergone previous treatment for alcohol addiction is brought to casualty by his wife, who reports him to be increasingly drowsy and difficult to rouse. There is no history of head injury. He has had recent problems sleeping and been given zopiclone (Zimovane) by his GP. His pills have been counted and there is no overdose. On examination he clearly has ascites and is generally tender. Blood tests reveal an iron deficiency picture, elevated transaminases and a bilirubin of 145 μmol/l, a random blood glucose concentration is 6.7 mmol/l. He has a mildly elevated white blood cell count. Which of the following is the most likely cause of his decreased conscious level?

A 62-year-old woman complains of diarrhoea, weight loss and abdominal pain with malaise and fever. She has oral ulcers, red itchy eyes and tender nodules on her shins. She has tenderness in the right iliac fossa and a vague right iliac fossa mass. What is the most likely diagnosis?

In a patient with liver cirrhosis which one of the listed features is characteristic of portal hypertension?

A 56-year-old man with severe exertional dyspnoea is admitted with jaundice and ascites. His father died of respiratory illness at 54 years of age. Bilirubin, AST and alkaline phosphatase are elevated. What is the most likely diagnosis?

A patient presents with acute fulminant hepatic failure. Which virus infection is most likely responsible for this?

A 52-year-old man presents with general deterioration. He drinks approximately 20 units of alcohol each week and is a smoker of five cigarettes daily. Examination reveals that he is jaundiced, has numerous spider naevi on his chest and he has a temperature of 37.2°C. Abdominal examination reveals hepato-splenomegaly. Investigations reveal: Bilirubin 100 micromol/L (1-22), Alkaline phosphatase 310 iu/l (45 – 105), ALT 198 iu/l (5 – 35), AST 158 iu/l (1 – 31), Albumin 25 g/L (37 – 49), Hepatitis B virus surface antigen positive, Hepatitis B virus e antigen negative, Hepatitis B virus DNA awaited. What is the most likely diagnosis?