Search Results for ‘gastroenterology-’

A 61-year-old woman conies to her doctor's office for steadily increasing abdominal girth and fatigue with mild exertion She has noticed this symptom for the past few months She reports a 5-kg (11-lb) increase in her weight without making any change in her regular diet Her past medical history...

A 60-year-old man conies to the emergency department because of a 2-day history of severe abdominal pain He denies nausea, vomiting, or diarrhea He does not drink alcohol or smoke cigarettes He has not traveled outside of the country and has no sick household contacts Examination shows mild...

A 48-year-old woman with diet-controlled diabetes reports difficulty swallowing for the last year She has difficulty swallowing both solids and liquids, and has an associated weight loss of about 20 lb She has no history of heartburn and takes no medications Abdominal examination is normal Chest...

A 58-year-old man comes to the clinic complaining of erectile dysfunction Over the past 6 months he has tried sildenafil and testosterone as well as a variety of herbal medications, but has had no success with these treatments Review of systems reveals complaints of some mild arthralgias and...

A 34-year-old woman presents to the emergency department with acute abdominal pain in her right upper quadrant The pain came on suddenly while she was at home watching a movie with her husband The patient reports that she has never felt this pain before and is also feeling lightheaded She denies...

A 56 year old woman comes to the clinic because her symptoms of epigastric pain from endoscopically confirmed duodenal ulcer have not responded to several weeks of PPI, clarithromycin and amoxicillin. What is the most appropriate next step in the management of this patient ? a. Refer for...

A 43 yeat old man recently diagnosed whith AIDS comes to the emergency department with pain on swallowitn that has vecome progressive worse ove the last several weeks.There is no pain when nor seallowitn.His CD4 count is 43 mm3 .The patient is not currently takinf any medication. What is the...

varices mx patient comes to ED, UGI bleeding. stopped with conservative mx. Endoscopy done. Varices found. what is next step for prevention of re-variceal bleeding ? endoscopic sclerotherapy\banding or beta blockers.

This is a good question from USMLERx 18 y.o. woman complaints of 3 months of recurrent abdominal pain, bloody diarrhea, and weight loss. Biopsy from a colonoscopy: mucosal involvement only, with crypt abscesses. Which of the following is true about this disease? a. bleeding from rectum...

A 62-year-old woman presents to her physician with complaints of heartburn, fatigue, and intermittent upper abdominal pain. The pain is often worse after meals and especially with spicy foods. She reports no recent nausea, vomiting, weight loss, dysphagia, or bright-red blood per rectum...

A 59-year-old woman with renal cell carcinoma presents to the emergency department with severe right upper quadrant (RUQ) pain. She is afebrile, acutely tender in the RUQ, and has shifting dullness and a palpable liver edge. Murphy’s sign is negative. Laboratory studies show: Na+: 138 mEq/L K+...

. A 36-year-old female with AIDS and a CD4 count of 35/mm 3 presents with odynophagia and progressive dysphagia. The patient reports daily fevers and a 20-lb weight loss. The patient has been treated with clotrima-zole troches without relief. On physical examination the patient is cachectic with...

A 69-year-old patient presents to the emergency department with hematochezia of 4 h duration. The pa-tient is pale but alert and oriented. Blood pressure is 107/ 82 mmHg, respiratory rate is 24 breaths/min and heart rate is 96 beats/min. The hematocrit is 24%, with a base-line of 32%. Which of...

A 23-year-old Turkish female presents to the emergency department for evaluation of acute abdominal pain. She reports that she has had multiple episodes of se-vere abdominal pain since age 15. These episodes have been very severe, once prompting exploratory laparot-omy at age 18 with removal of...

A 54-year-old male presents with 1 month of diar-rhea. He states that he has 8 to 10 loose bowel movements a day. He has lost 8 lb during this time. Vital signs and physical examination are normal. Serum laboratory stud-ies are normal. A 24-h stool collection reveals 500 g of stool with a...

You are asked to consult on a 62-year-old white female with pruritus for 4 months. She has noted progressive fatigue and a 5-lb weight loss. She has intermittent nausea but no vomiting and denies changes in her bowel habits. There is no history of prior alcohol use, blood transfusions, or...

A 24-year-old woman with a history of irritable bowel syndrome (IBS) has been treated with loperamide, psyllium, and imipramine. Because of continued abdom-inal pain, bloating, and alternating constipation/diarrhea, she is started on alosetron, 0.5 mg bid. Five days later she is brought to the...

A 61-year-old male is admitted to your service for swelling of the abdomen. You detect ascites on clinical examination and perform a paracentesis. The results show a white blood cell count of 300 leukocytes/µL with 35% polymorphonuclear cells. The peritoneal albumin level is 1.2 g/dL, protein is...

A 38-year-old male presents to his physician with 4 to 6 months of weight loss and joint complaints. He re-ports that his appetite is good, but he has had diarrhea with six to eight loose, foul-smelling stools each day. He has also had migratory pain in the knees and shoulders. Stool studies...

A 57-year-old man with peptic ulcer disease experi-ences transient improvement with Helicobacter pylori eradi-cation. However, 3 months later, symptoms recur despite acid-suppressing therapy. He does not take nonsteroidal anti-inflammatory agents. Stool analysis for H. pylori anti-gen is...