Category: Gastroenterology & Hepatology

FCEM2-0712

A 42 year old male intravenous drug user is brought to the emergency department due to worsening abdominal distension, fever and new onset confusion. You observe that the patient has a pre-existing diagnosis of hepatitis C but has not attended follow up or received treatment. After evaluating the patient, you notice that he has tense ascites and decide to perform abdominal paracentesis. Ascitic fluid is sent for analysis.

Which of the following findings is indicative of spontaneous bacterial peritonitis (SBP)?

FCEM2-0713

A 32-year-old woman with a history of alcoholic liver disease comes in with a fever, abdominal pain, ascites, and worsening hepatic encephalopathy. The doctor suspects spontaneous bacterial peritonitis. Which ONE statement is correct regarding this diagnosis?

FCEM2-0714

A 35-year-old man with a known history of alcohol dependency (consuming over 1L of whisky daily) and liver cirrhosis comes to the hospital with worsening ascites and abdominal pain. He is experiencing encephalopathy and has had multiple episodes of diarrhea today. His vital signs are as follows: heart rate of 116, blood pressure of 100/68, and a temperature of 38.9oC. Upon examination, he has significant ascites and generalized abdominal tenderness.

What is the most likely diagnosis in this case?

FCEM2-0715

A 35-year-old woman with a long-standing history of heavy alcohol abuse and liver cirrhosis comes in with a fever, abdominal pain, worsening ascites, and confusion.

Which antibiotic should be administered in this case?

FCEM2-0716

A 35-year-old woman with a long-standing history of heavy alcohol abuse and liver cirrhosis presents with a fever, abdominal pain, worsening ascites, and confusion.

What is the SINGLE most appropriate initial investigation?

FCEM2-0717

A 45-year-old woman with a longstanding history of heavy tobacco use and lung cancer presents with cough, chest pain, worsening shortness of breath, and fatigue.

What is the SINGLE most likely diagnosis?

FCEM2-0718

A 4 year old girl is brought into the emergency department with a two day history of sudden onset watery diarrhea accompanied by stomach cramps and feelings of nausea. Your consultant inquires if you intend to submit a stool sample for microbiological analysis. What would be a reason to send a stool sample for microbiological testing?

FCEM2-0719

A 68 year old male is brought into the emergency department after a significant episode of haematemesis. The patient is transferred to the resuscitation bay upon arrival, and large bore intravenous access is established while blood samples are sent for analysis and cross matching. You observe that the patient has a medical history of liver cirrhosis and suspect a bleed from oesophageal varices.

Which of the following medications should be prioritized for administration, as it has been proven to enhance survival in patients with gastro-oesophageal variceal bleeding?

FCEM2-0706

A 72-year-old male visits the emergency department on a weekend complaining of colicky abdominal pain and frequent episodes of diarrhea. The patient mentions that he had given a stool sample to his GP earlier in the week, but he is worried because the diarrhea has worsened. The pathology report confirms the presence of clostridium difficile toxin in the stool sample. Which of the medications the patient regularly takes are known to increase the risk of clostridium difficile diarrhea?

FCEM2-0707

A 35-year-old woman comes to the clinic complaining of difficulty swallowing for the past 6 months. Her dysphagia affects both solids and liquids and has been getting worse over time. Additionally, she has noticed that her fingers turn purple when exposed to cold temperatures. On examination, her fingers appear swollen and the skin over them is thickened. There are also visible telangiectasias.
Which of the following autoantibodies is most specific for the underlying condition in this case?