A 32-year-old woman comes in with a 4-month history of increasing fatigue, occasional diarrhea, and occasional abdominal pain. A blood test is ordered, which reveals microcytic anemia. She is then referred for a colonoscopy, and a biopsy is performed. The biopsy report indicates the presence of non-caseating granulomas with transmural inflammation.
What is the MOST LIKELY diagnosis in this case?
A 62 year old female presents to the emergency department after experiencing episodes of vomiting blood. The patient reports feeling nauseated on and off for several days prior to the vomiting, but became concerned when she noticed that the vomit consisted mostly of bright red blood. She has no regular medication and denies any significant medical history. The patient states that she consumes approximately 12 units of alcohol per week and quit smoking 10 years ago.
What is the most probable underlying cause of this patient’s symptoms?
A 35 year old female presents to the emergency department complaining of abdominal cramps and bloating. She informs you that she has not had a bowel movement for 2 days. Blood tests are conducted, but all results come back within normal ranges. The patient’s vital signs are all normal, and she does not have a fever. She discloses that she has been experiencing recurrent abdominal pain and bloating for the past 6-9 months and has consulted her primary care physician about it. Based on the symptoms, you suspect constipation predominant irritable bowel syndrome and decide to prescribe a laxative. However, you need to be cautious about prescribing certain medications for patients with irritable bowel syndrome. Which of the following medications should be avoided in these patients?
A 35 year old accountant presents to the emergency department with a 3 day history of diarrhea, stomach cramps, and occasional vomiting. After evaluating the patient, you inform them that they are likely experiencing viral gastroenteritis and provide instructions for self-care at home. The patient inquires about when it would be appropriate for them to return to work.
A 62 year old male is brought into the emergency department by concerned family members. They inform you that the patient is a heavy drinker but appeared very confused and disoriented, which is unusual for him. The patient scores 4/10 on the abbreviated mental test score (AMTS). Upon examination, you observe that the patient has yellowing of the eyes, shifting dullness on abdominal palpation, dilated abdominal veins, and asterixis. The patient’s vital signs and initial blood tests are as follows:
Blood pressure: 122/80 mmHg
Pulse: 92 bpm
Respiration rate: 18 bpm
Temperature: 37.7ºC
Bilirubin: 68 µmol/l
ALP: 198 u/l
ALT: 274 u/l
Albumin: 26 g/l
INR: 1.7
What is the most likely diagnosis?
A 45-year-old patient with abdominal pain and abnormal liver function tests undergoes screening for hepatitis and is found to be immune.
Which ONE blood test result is indicative of natural immunity to hepatitis B in this patient?
A new Emergency Department nurse is required to verify her immunity to hepatitis B before starting her position. She has received a hepatitis B vaccination series in the past but cannot remember the specific dates.
What ONE blood test result would indicate that she has developed immunity as a result of her hepatitis B vaccination?
A patient presenting with abdominal pain and abnormal liver function tests undergoes hepatitis screening and is found to have chronic hepatitis B infection.
Which ONE blood test result is indicative of a patient being chronically infected with hepatitis B?
A patient presents with fatigue, loss of appetite, yellowing of the skin, and pain in the upper right side of the abdomen. The doctor suspects a diagnosis of acute hepatitis B.
Which of the following blood test results is most indicative of an acute hepatitis B infection?
A 28-year-old man is being investigated for a potential acute hepatitis B infection. What is the earliest sign of acute infection in acute hepatitis B?