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Chapter: 1 / Q: 51
A 34-year-old man with ulcerative colitis presents in the gastroenterology outpatient clinic with abdominal pain and fatigue. He states the pain has been intermittent for the past 2 weeks and has not settled with simple analgesia. Focussed questioning reveals that the pain is distinct
Chapter: 1 / Q: 52
A 52-year-old man presents to hospital complaining of abdominal pain and diarrhoea. He has had 10 bouts of diarrhoea since the morning and states that the pain is severe. He has noticed that his bowels have become much more watery over the past 2 months and that he has been increasingly
Chapter: 1 / Q: 53
A 26-year-old man was admitted by ambulance suffering with severe headaches. He described the headaches as the worst pain he had ever experienced and mentioned that concurrently he felt unsteady and drunk. He described the pain as being occipital in location and of rapid onset, being continuous
Chapter: 1 / Q: 54
Relatives of a 70-year-old lady were concerned that she appeared to be increasingly confused. On examination she was orientated in time, place and person but did have slurred speech. Further neurological examination revealed bilateral past pointing and trunkal ataxia with no evidence
Chapter: 1 / Q: 55
A 70-year-old gentleman who is known to be taking warfarin is admitted to hospital with left-sided weakness. He has a history of coronary artery disease for which he is taking the warfarin but examination reveals no other findings of note. Which of the following investigations is the most
Chapter: 1 / Q: 56
A 24-year-old lady presents with progressive seizure-like jerking movements of all extremities. She has three siblings all of whom are normal; although a cousin was thought to have suffered with a similar illness and died prematurely at the age of 37 years. No diagnosis was made for her cousin
Chapter: 1 / Q: 57
A 50-year-old man presents to his GP with headache, tenderness over the scalp and a general feeling of being tired all the time. Focused questioning reveals he also suffers with muscular aches and feels he has been a bit slow of late. Routine bloods were sent off and a 2-week appointment is made
Chapter: 1 / Q: 58
A 30-year-old woman was admitted to casualty with a 24-hour history of worsening headaches. She described the headaches as constant with no relieving factors and associated nausea but on direct questioning she confirms that the pain is exacerbated by strong light. On examination there
Chapter: 1 / Q: 59
A 54-year-old man presents feeling unwell with a failure to pass urine for 24 hours. Blood results taken on admission show a raised urea and creatinine and his blood pressure lying is 165/92. Abdominal palpation reveals a suprapubic dome-shaped mass that is dull to percussion
Chapter: 1 / Q: 60
A 46-year-old woman recently returned from visiting her relatives in Bangladesh. Shortly after her return she developed a fever, became unwell and complained of an ache in her left flank. Detailed questioning reveals a 7k weight loss since her return 3 weeks ago and diarrhoea that has
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