Search results for "Hepatology"
MKSAP Quiz: 3-month history of progressively worsening diarrhea
A 19-year-old woman is evaluated for a 3-month history of progressively worsening diarrhea, abdominal pain, and weight loss. Her brother was diagnosed with Crohn disease at age 16 years. Following a physical exam and colonoscopy, what is the most effective maintenance treatment?
https://immattersacp.org/weekly/archives/2013/07/30/3.htm
30 Jul 2013
MKSAP Quiz: Fever and abdominal pain
A 45-year-old man is admitted to the hospital for a 2-day history of fever and abdominal pain. His medical history is notable for cirrhosis due to chronic hepatitis C, esophageal varices, ascites, and minimal hepatic encephalopathy. Abdominal ultrasound discloses cirrhosis, splenomegaly, and ascites. His albumin level is consistent with spontaneous bacterial peritonitis. What is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2013/05/07/3.htm
7 May 2013
MKSAP Quiz: ED evaluation for acute onset of pain
A 37-year-old woman is evaluated in the emergency department for the acute onset of pain after 2 weeks of bloody diarrhea. The diarrhea has escalated to 15 times per day. She has ulcerative colitis that was diagnosed 2 years ago. She currently takes azathioprine. On physical examination, she appears ill. Following aggressive fluid resuscitation, temperature is 38.9° C (102.0° F), blood pressure is 70/40 mm Hg, pulse rate is 148/min, and respiration rate is 35/min. Abdominal examination discloses absent bowel sounds, distention, and diffuse marked tenderness with mild palpation. Following lab studies and the results of a radiograph, what is the most appropriate management?.
https://immattersacp.org/archives/2014/01/mksap.htm
1 Jan 2014
MKSAP Quiz: 10-day history of malaise, discomfort and progressive jaundice
A 32-year-old woman is evaluated for a 10-day history of malaise, right upper quadrant discomfort, and progressive jaundice. She has had no recent travel outside of the United States, does not drink alcohol, and has no recent ingestions of drugs, including acetaminophen or herbal remedies. Up until this time, she has been healthy. She has a history of type 1 diabetes mellitus for which she takes insulin glargine and insulin detemir. Following a physical exam and lab results, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2013/10/29/3.htm
29 Oct 2013
MKSAP Quiz: persistent heartburn and regurgitation
A 50-year-old man is evaluated for persistent heartburn and regurgitation despite taking a high-dose proton-pump inhibitor twice a day for 6 months. His symptoms have improved, but he continues to have symptoms many times a week. He has not had dysphagia, chest pain or weight loss. He has significantly modified his diet. His only medication is esomeprazole, 40 mg twice a day, which he takes as directed. Endoscopy reveals persistent esophagitis and a moderately large hiatal hernia. His BMI is 34. What is the most appropriate next step in treatment?
https://immattersacp.org/weekly/archives/2014/02/04/3.htm
4 Feb 2014
Long-term view for chronic pancreatitis
Unlike acute cases of pancreatitis, chronic cases present with varying degrees and types of pain, and without other clinical indicators such as calcification or damage to pancreatic ducts. It's best to refer to a gastroenterologist early to clarify the diagnosis, so the internist can better manage the patient.
https://immattersacp.org/archives/2014/01/pancreatitis.htm
1 Jan 2014
Refusal of treatment can present some tricky ethical dilemmas
This issue includes stories on informed refusal and on managing psoriasis.
https://immattersacp.org/archives/2014/02/editors.htm
1 Feb 2014
Functional gut disorders become clearer as models emerge
One major finding is that irritable bowel syndrome and functional dyspepsia are connected.
https://immattersacp.org/archives/2019/01/functional-gut-disorders-become-clearer-as-models-emerge.htm
1 Jan 2019
MKSAP Quiz: Evaluation for newly developed ascites
A 50-year-old man is evaluated for newly developed ascites. He has cirrhosis due to nonalcoholic steatohepatitis. Following a physical exam and lab studies, what is the most appropriate additional treatment?
https://immattersacp.org/weekly/archives/2021/08/31/3.htm
31 Aug 2021
MKSAP Quiz: Difficult and painful swallowing
A 43-year-old man is evaluated for difficulty with swallowing and painful swallowing. The pain began approximately 5 days ago and occurs with both solids and liquids. He has recently diagnosed HIV infection and is receiving antiretroviral therapy. Following a physical exam and lab studies, what is the most appropriate treatment?
https://immattersacp.org/archives/2022/09/mksap-quiz-difficult-and-painful-swallowing.htm
1 Sep 2022