Gastroenterology and Hepatology Case Studies

Flashcards covering medical case management, diagnostic markers, and treatment protocols for various gastroenterological and hepatological conditions based on clinical presentation and laboratory results.

Empyema

A diagnosis characterized by high-grade fever, pleuritic chest pain, early clubbing, and pleural fluid analysis showing a pH of $7.0$.

Iron Deficiency Anemia Workup

In a 59-year-old woman with Hb $95\,g/L$, MCV $68\,fl$, and Ferritin $3\,pg/L$, the most appropriate next step in management is endoscopy and colonoscopy.

Intrinsic Factor Antibodies

The diagnostic test ordered for a patient with patches of vitiligo, macrocytic anemia (MCV $103\,fl$), and a low Vitamin B12 level of $122\,ng/L$.

Crohn's Disease

A condition presenting with non-bloody diarrhea, oral ulcers, recurrent abdominal cramps, weight loss, and a tender right lower quadrant.

Urea Breath Test

The most appropriate test used to ensure the eradication of $H.\,pylori$ after treatment.

Primary Sclerosing Cholangitis (PSC)

A condition likely in a patient with a history of ulcerative colitis who develops progressive fatigue, pruritus, jaundice, and multiple short strictures of the biliary tree on MRCP.

Acute Pancreatitis

A diagnosis for severe epigastric pain radiating to the back, nausea, vomiting, and an abdominal X-ray showing an air-filled intestinal loop (sentinel loop) in the left upper quadrant.

Spontaneous Bacterial Peritonitis (SBP) Management

The next step in management for a patient with chronic Hepatitis C and ascites when an ascitic tap reveals a neutrophil count of $400/mm^3$ ($>250/mm^3$) is intravenous antibiotics.

Hepatitis B Vertical Transmission Prevention

To reduce transmission risk from an HBV-positive mother with a high viral load, the baby should receive both the Hepatitis b vaccine and immunoglobulin.

Cholestasis of Pregnancy

A diagnosis for a 30-week pregnant woman with pruritus and jaundice, but no fever or abdominal pain, showing an Alkaline phosphatase level of $700\,IU/L$.

Hepatocellular Carcinoma (HCC)

A likely diagnosis in an alcoholic patient with weight loss, fever, right hypochondrium pain, a focal liver lesion on ultrasound, and an Alpha fetoprotein level of $120\,ng/mL$.

HBsAg (Hepatitis B Surface Antigen)

The first evidence or marker of an acute Hepatitis B infection.

Hepatitis C Transmission Risk

The approximate likelihood of Hepatitis C transmission after a needle stick injury is $3\, \%$.

Celiac Disease Diagnosis

A condition suspected in a patient with chronic diarrhea, malabsorption, and an MCV of $70\,fl$, often diagnosed using IgA anti-endomysial antibodies.

Barrett's Esophagus

A diagnosis resulting from chronic heartburn where upper GI endoscopy reveals intestinal-type metaplasia at the distal esophagus.

Wilson's Disease

A diagnosis for a patient with tremors, dysarthria, dyskinesia, and a greenish-brown ring at the corneoscleral junction.

Hemochromatosis

A condition presenting with bronze-colored skin, jaundice, arthralgia, diabetes mellitus, hepatomegaly ($15\,cm$ span), and a heart examination revealing a 3rd heart sound.

Endoscopic Hemostasis (IV PPI duration)

Following endoscopic hemostasis with an endo clip for a duodenal ulcer with a visible vessel, IV PPI should be continued for $72\,hours$.

Achalasia

A diagnosis for progressive dysphagia involving both solids and liquids, associated with nocturnal cough and central chest discomfort.

MALT Lymphoma Management

The best management option for mucosa-associated lymphoid tissue (MALT) lymphoma with numerous $H.\,pylori$ organisms and a normal CT scan is $H.\,pylori$ eradication.

Carcinoid Syndrome

A condition suggested by flushing, abdominal cramps, watery diarrhea, wheezing, and a systolic murmur, diagnosed by testing urine for $5$-hydroxindoleacetic acid ($5\text{-HIAA}$).

Psyllium

A bulking agent used as the most appropriate treatment for chronic constipation in patients without alarm symptoms and normal laboratory workup.

Clostridium difficile Treatment in IBD

The most appropriate treatment for an ulcerative colitis patient on immunosuppressants who tests positive for $Clostridium\,difficile$ toxins is oral vancomycin.

Pneumatic Dilation

The best treatment option for a patient with progressive dysphagia diagnosed as achalasia.