EMQs for Medical Students - PasTest

More documents

Recommendations

Info

E M Q s F O R M E D I C A L S T U D E N T S – V O L U M E 2 2. THEME: VOMITING A B C D E F G H I J Acute abdomen Central nervous system causes Drug therapy Gastroenteritis due to Bacillus cereus Gastroenteritis due to Salmonella spp. Gastroenteritis due to Staphylococcus aureus Gastric outflow obstruction Large-intestinal obstruction Small-intestinal obstruction Uraemia The patients below have all presented with vomiting. Please select the most appropriate cause from the above list. Each cause may be used once, more than once or not at all. 1. An 80-year-old woman is accompanied by her daughter to the Emergency Department. She gives a 2-day history of nausea and vomiting and is slightly confused. Her past medical history includes atrial fibrillation, osteoarthritis and recently diagnosed hypertension. She was started on a low-dose bendroflumethiazide 3 weeks ago by her GP. She claims to have been compliant with her medications, which include digoxin and co-dydramol. On examination, her temperature is 36.8 °C, her pulse is 56 beats per minute (bpm), irregularly irregular and her blood pressure (BP) is 145/85 mmHg. There is mild epigastric tenderness. Her urea and electrolytes (U&Es) are: Na + 138 mmol/l, K + 3.1 mmol/l, urea 8.6 mmol/l, creatinine 142 mmol/l. 2. A 25-year-old student gives an 8-hour history of frequent vomiting, being ‘unable to keep anything down’. He also has some cramp-like abdominal pain. On general examination he appears pale and clammy and is shivering; abdominal examination is unremarkable. There is no previous medical history or drug history. Investigations show: haemoglobin 14.7 g/dl, white cell count (WCC) 11.8 × 10 9 /l, platelets 368 × 10 9 /l; Na + 135 mmol/l, K + 3.4 mmol/l, urea 7.7 mmol/l, creatinine 70 mmol/l. 3. A 4-week-old baby is admitted with a 4-day history of projectile vomiting of large amounts of curdled milk shortly after every feed. This pattern is observed in hospital and a 2-cm, palpable mass is felt on palpation in the epigastric region during feeding. Investigations show: haemoglobin 17.0 g/dl, WCC 4.6 × 10 9 /l, platelets 170 × 10 9 /l; Na + 131 mmol/l, K + 2.9 mmol/l, urea 7.5 mmol/l, creatinine 43 mmol/l. 4. A 22-year-old woman presents with a 3-day history of colicky, central abdominal pain and vomiting. The pain is partially relieved by vomiting and the vomitus is described as dark-green. On examination, she is dehydrated and the abdomen is distended but non-tender to palpation. She has previously had an appendectomy <strong>for</strong> appendicitis that was complicated by peritonitis. Investigations show: haemoglobin 10.6 g/dl, WCC 11.1 × 10 9 /l, platelets 454 × 10 9 /l; Na + 130 mmol/l, K + 3.3 mmol/l, urea 10.0 mmol/l, creatinine 100 mmol/l. 6
G A S T R O E N T E R O L O G Y 5. A 12-year-old boy presents with a 12-hour history of abdominal pain, nausea and vomiting. On examination, he is febrile (38.8 °C), tachycardic, and has tenderness and guarding in the right iliac fossa. The full blood count (FBC) shows: haemoglobin 13.6 g/dl, WCC 14.1 × 10 9 /l, platelets 325 × 10 9 /l. 7
Page 1 and 2: EMQs for Medical Students Volume 2
Page 3: CHAPTER 1 Gastroenterology 1. Anato
Page 8 and 9: E M Q s F O R M E D I C A L S T U D
Page 20 and 21: ANSWERS TO CHAPTER - GASTROENTEROLO
Page 22 and 23: A N S W E R S - G A S T R O E N T E
Page 30: A N S W E R S - G A S T R O E N T E

EMQs for Medical Students - PasTest

Create successful ePaper yourself

Delete template?

Save as template?