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Mike is 32 years old and has Crohn’s disease. He attends the GP surgery with his partner Michelle, as they want to start a family soon. Mike is concerned about the effect his Crohn’s disease will have on their ability to conceive and has read about this on the internet. Which one of the following …
Margaret is 35 years old and has recently been diagnosed with Coeliac disease, after initially presenting with weight loss, bloating and fatigue. You review her in a follow up gastroenterology clinic and are discussing ongoing management and reviews. Which one of the following tests is least likely to be carried out in routine annual blood …
Mr Thomas is a 62 year old retired solicitor who presents to the GP with a 6 month history of weight loss and diarrhoea. He estimates he has lost roughly 6kg over this time despite his usual oral intake. There is no rectal bleeding, abdominal pain or family history of malignancy. Past medical history includes …
Edward is a 57 year old Caucasian architect with a 3 month history of lethargy and more recently erectile dysfunction. He is in a happy relationship and denies any stress. He is a non-smoker and drinks no alcohol. You comment that he looks very tanned, and he agrees saying that his family have observed this …
You see a 52 year old male who has come for the results of his recent NHS health check blood tests. You inform him that the serum GGT (gamma-glutamyl transferase) was raised and proceed to take a history to establish the reasons for this. Which of the below reasons could cause the GGT to be …
Mrs Turner is a 54 year old lady who has been discharged from the gastroenterology clinic following an oesophago-gastro duodenoscopy, which demonstrates severe oesophagitis. What is the most appropriate initial management option?
A 66 year old woman presents with fatigue, upper abdominal discomfort and itching. On examination, she has hepatomegaly, jaundice and hyperpigmentation. You request a liver screen blood test, which reveals that her ALT is 189 U/L (normal less than 50 U/L), AST is 174 U/L (normal less than 50 U/L), Alkaline Phosphatase is 757 U/L …
A 25 year old woman presents to the GP following a private health check. She reports no symptoms and her examination is normal. Her blood test demonstrates that her ALT is 31 U/L (normal less than 35 U/L), AST is 29 U/L (normal less than 35 U/L), Alkaline Phosphatase is 111 U/L (normal range, 30-130 …
Sam is a 33 year old solicitor who is known to have Irritable bowel syndrome and has been struggling with abdominal cramps despite using various antispasmodic drugs and peppermint oil capsules. Paracetamol has little effect. He used to have predominant diarrhoea symptoms, but these are controlled well with changes to his diet. There is no …
Adam is a 33 year old builder who presents with a 2 hour history of epigastric abdominal pain which radiates to his back and vomiting. Vital observations are stable except for temperature 37.7 °C and abdominal examination reveals generalised abdominal tenderness. Based on the likely diagnosis, which one of the following medications is most likely …
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