Search results for "Hepatology"
MKSAP Quiz: Follow-up of ulcerative colitis
A 38-year-old man is evaluated during a routine examination. He was diagnosed with ulcerative colitis 10 years ago and is currently asymptomatic. His last colonoscopy, performed at the time of diagnosis, showed mildly active extensive colitis extending to the hepatic flexure. Physical and abdominal examinations are normal. What is the most appropriate colonoscopy interval for this patient?
https://immattersacp.org/weekly/archives/2013/01/08/3.htm
8 Jan 2013
MKSAP Quiz: 2-year history of chest pain
A 35-year-old man is evaluated for a 2-year history of intermittent chest pain that is retrosternal, lasts for seconds to minutes, is unrelated to exertion, and does not radiate. It is occasionally associated with swallowing. Upper endoscopy is normal and a barium swallow is shown. What is the most likely diagnosis?.
https://immattersacp.org/archives/2013/02/mksap.htm
1 Feb 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: 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: 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: 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
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
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
MKSAP Quiz: 6-month history of dysphagia
A 50-year-old man is evaluated for a 6-month history of dysphagia. He describes a sensation of both solids and liquids sticking in the midesophageal area. This sensation has slowly worsened over time. He also describes intermittent midsternal discomfort that is nonexertional and is usually precipitated by swallowing food. He has lost 4.5 kg (10.0 lb). He has had no history of heartburn or acid regurgitation. Following a physical exam and barium swallow, what is the most appropriate management?.
https://immattersacp.org/archives/2014/03/mksap.htm
1 Mar 2014