Results for “gastrointestinal”

A 68-year-old man with metastatic oesophageal cancer develops a symptomatic proximal deep vein thrombosis. He completed treatment for melaena from the tumour tw…

Cardiovascular · Clinical rotations · middle twist

A 76-year-old man with persistent atrial fibrillation develops sudden severe abdominal pain and vomiting. He is pale and distressed, but his abdomen is initiall…

Emergency and Toxicology · Clinical rotations · middle twist

A 66-year-old man is admitted with melaena from a duodenal ulcer and undergoes successful endoscopic haemostasis. He has taken aspirin 100 mg daily since a myoc…

Cardiovascular · Clinical rotations · middle twist

A 69-year-old man has had three episodes of melaena over two months and requires repeated iron infusions. He takes no non-steroidal anti-inflammatory drugs and…

Gastroenterology and Hepatology · Clinical rotations · common

A 67-year-old man presents with recurrent passage of bright-red blood and clots. After initial fluid replacement, his blood pressure is 126/74 mmHg and pulse is…

Cardiovascular · Clinical rotations · middle twist

A 64-year-old woman with cirrhosis presents with fresh haematemesis and melaena. After intravenous access, cautious crystalloid and cross-matched blood have bee…

Cardiovascular · Clinical rotations · middle twist

A 26-year-old man is referred for recurrent episodes of yellowing of the eyes, usually after intercurrent illness. He has no pruritus, abdominal pain or weight…

Gastroenterology and Hepatology · Mechanisms of disease · niche

A 32-year-old woman at 34 weeks gestation reports two weeks of intense itching that is worse at night and began on her hands and feet. She has no rash, abdomina…

Obstetrics and Gynaecology · Clinical rotations · common

A 34-year-old man with established primary sclerosing cholangitis develops worsening pruritus and jaundice over six weeks, with a 5 kg weight loss. His bilirubi…

Gastroenterology and Hepatology · Clinical rotations · middle twist

A 47-year-old woman has fatigue, pruritus and intermittent jaundice. Alanine aminotransferase is 680 U/L (5–40), IgG is 31 g/L (7–16), antinuclear and smooth-mu…

Gastroenterology and Hepatology · Clinical rotations · common

A 29-year-old woman is admitted with nausea, jaundice and right upper-quadrant discomfort. Her alanine aminotransferase is 9200 U/L (5–40), aspartate aminotrans…

Cardiovascular · Clinical rotations · middle twist

A 42-year-old man presents with several months of pruritus followed by yellowing of the eyes. He has ulcerative colitis, an alkaline phosphatase of 680 U/L (30–…

Gastroenterology and Hepatology · Clinical rotations · common

A 29-year-old man presents two days after running out of prescribed oxycodone, which he had been taking in increasing amounts for a year. He is yawning, restles…

Emergency and Toxicology · Clinical rotations · common

A 68-year-old man with chronic kidney disease is admitted with pneumonia and has received intravenous fluids, calcium gluconate and insulin with glucose for a s…

Renal, Urology and Electrolytes · Clinical rotations · middle twist

A 79-year-old woman with a previous stroke develops fever, cough and a new right lower-zone infiltrate 36 hours after vomiting during a meal. She is alert, has…

Infectious Diseases · Clinical rotations · middle twist

A 26-year-old man with schizophrenia stopped taking lorazepam prescribed for recurrent episodes of immobility and mutism. Two days later he is mute, alternates…

Psychiatry and Mental Health · Clinical rotations · niche

A 34-year-old woman with schizoaffective disorder becomes restless, sweaty and confused six hours after venlafaxine was increased and tramadol was prescribed fo…

Emergency and Toxicology · Mechanisms of disease · common

A 66-year-old man with metastatic gastric adenocarcinoma develops a symptomatic proximal deep vein thrombosis. He has a friable gastric lesion with recent occul…

Cardiovascular · Clinical rotations · middle twist

A 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…

Emergency and Toxicology · Clinical rotations · common

A 46-year-old woman with bipolar disorder has been stable on lithium carbonate for five years. She presents with two days of nausea, vomiting and unsteadiness o…

Psychiatry and Mental Health · Clinical rotations · common