EMQs in Clinical Medicine.pdf - Peshawar Medical College

164 The abdomen and surgery
76 Abnormal abdominal radiographs
A
B
C
D
E
F
Crohn’s disease
diverticulosis
chronic pancreatitis
acute pancreatitis
gluten-sensitive enteropathy
acute appendicitis
G
H
I
J
K
L
sigmoid volvulus
intussusception
ulcerative colitis
pyloric stenosis
small bowel obstruction
perforated ulcer
For each clinical scenario below, give the most likely cause for the clinical
findings. Each option may be used only once.
1 A 55 year old with a history of epigastric discomfort of several months presents
acutely unwell in A&E. His radiograph shows free gas under the diaphragm.
2 Abdominal film of an elderly constipated woman shows an ‘inverted U’ loop of
bowel.
3 A 31-year-old man presents with fever and bloody diarrhoea. He is tachycardic
and has a Hb of 10.0 g/dl. Abdominal film shows loss of haustral pattern and a
colonic dilatation of 8 cm.
4 A 26-year-old student presents with bloody diarrhoea, abdominal pain and
weight loss. Barium enema reveals ‘cobble-stoning’ and colonic strictures.
5 A 45-year-old man presents with severe epigastric pain and vomiting.
Abdominal film shows absent psoas shadow and ‘sentinel loop’ of proximal
jejunum.
Answers: see page 190.