Gastroenterology 2- 256-454AKT for KFP easy

Which endoscopic procedure is commonly used to evaluate the extent and severity of ulcerative colitis and monitor disease activity over time?

Which of the following extra intestinal manifestations can occur in patients with ulcerative colitis?

Which of the following medications is considered a first-line therapy for inducing remission in patients with mild to moderate ulcerative colitis?

Which of the following surgical procedures is considered curative for ulcerative colitis?

Which of the following medications is a monoclonal antibody that targets interleukin-23 and is used for inducing and maintaining remission in patients with moderate to severe ulcerative colitis who have not responded to conventional therapies?

Which of the following complications of ulcerative colitis is characterized by severe inflammation and dilation of the colon, leading to a risk of perforation?

Which of the following complications of ulcerative colitis is characterized by the development of inflammation and ulcers in the eyes, leading to symptoms such as eye pain, redness, and blurred vision?

Which of the following complications of ulcerative colitis is characterized by the development of chronic inflammation and fibrosis in the bile ducts, leading to bile duct narrowing and potential liver damage?

Which of the following is not considered a common cause of chronic diarrhea?

Which of the following infectious agents is known to cause chronic diarrhea in immunocompromised individuals, such as those with HIV/AIDS or undergoing chemotherapy?

Which of the following conditions is characterized by chronic diarrhea that is often greasy, foul-smelling, and associated with malabsorption of nutrients?

Which of the following medications is commonly associated with the development of chronic diarrhea due to its laxative effect?

Which of the following risk factors is not associated with an increased risk of colorectal carcinoma?

Which of the following genes is commonly mutated in hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome?

Which of the following types of colorectal polyps is most likely to progress to colorectal carcinoma if left untreated?

A 65-year-old female presents with iron-deficiency anaemia, fatigue, and a recent change in bowel habits, including the passage of dark, tarry stools. She denies any significant abdominal pain. Physical examination reveals pallor. A faecal occult blood test (FOBT) is positive. What is the most likely diagnosis?

A 60-year-old female presents with a history of rectal bleeding and recent changes in bowel habits. Physical examination does not reveal any significant abnormalities. Which of the following investigations is the most appropriate initial step in evaluating this patient?

A 55-year-old male with a family history of colorectal cancer presents for routine screening. He is asymptomatic and has no significant medical history. Which of the following investigations is the most appropriate initial screening test for this patient?

A 65-year-old male presents with a recent diagnosis of colorectal cancer. He is scheduled for surgical resection of the tumour. Which of the following investigations is important to determine the extent of the disease and identify possible metastases before surgery?

Which of the following is a hallmark symptom of irritable bowel syndrome (IBS)?

Which of the following factors is known to exacerbate symptoms in individuals with irritable bowel syndrome (IBS)?

Which of the following dietary modifications is commonly recommended for individuals with irritable bowel syndrome (IBS) who experience bloating and gas?

Which of the following alarm symptoms warrants further investigation in a patient suspected to have irritable bowel syndrome (IBS)?

Which of the following psychological therapies has been shown to be effective in managing symptoms of irritable bowel syndrome (IBS)?

A 25-year-old female presents with nausea and vomiting. She reports a recent history of severe headaches, sensitivity to light, and neck stiffness. On physical examination, there is evidence of photophobia and nuchal rigidity. What is the most likely cause of her vomiting?

An 8-year-old child presents with vomiting and abdominal pain. The parents report that the child has recently returned from a camping trip and consumed untreated water from a stream. What is the most likely cause of the child’s symptoms?

A 60-year-old male with a history of alcohol abuse presents with persistent vomiting of bright red blood. On physical examination, he appears pale and has signs of cirrhosis, including ascites and jaundice. What is the most likely cause of his vomiting?

A 45-year-old female presents with vomiting and abdominal pain. She reports a recent history of taking nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of chronic knee pain. On physical examination, she has tenderness in the epigastric region. What is the most likely cause of her symptoms?

A 30-year-old male presents with vomiting and abdominal pain, specifically in the right lower quadrant. On physical examination, he has tenderness and rebound tenderness in the right lower abdomen. He also reports a recent episode of low-grade fever. What is the most likely cause of his symptoms?

A 55-year-old female with a history of diabetes presents with persistent vomiting and severe upper abdominal pain. On physical examination, there is evidence of epigastric tenderness, and laboratory tests show elevated serum amylase and lipase levels. What is the most likely cause of her symptoms?

A 35-year-old male presents with chronic constipation. He reports a history of a sedentary lifestyle and a diet low in fibre and fluids. On physical examination, there is evidence of abdominal distension and discomfort on palpation. What is the most likely cause of his constipation?

A 28-year-old female presents with complaints of constipation and bloating. She reports a history of abdominal surgeries, including removal of a portion of her small intestine. What is the most likely cause of her constipation?

A 35-year-old male presents with chronic constipation. He reports intermittent lower left abdominal pain and occasional rectal bleeding. On physical examination, there is tenderness and fullness in the left lower quadrant. What is the most likely cause of his constipation?

A 50-year-old female presents with chronic constipation and a history of long-standing type 2 diabetes. She reports difficulty in emptying her bladder completely. On physical examination, there is evidence of reduced anal sphincter tone. What is the most likely cause of her constipation?

A 30-year-old male presents with chronic constipation, He is taking thyroid hormone replacement therapy. On physical examination, there are no abnormal findings. What is the most likely cause of his constipation?

A 40-year-old female presents with sharp, right lower quadrant abdominal pain, fever, and tenderness upon palpation. Laboratory tests show an elevated white blood cell count. What is the most likely cause of her abdominal pain?

A 30-year-old male presents with colicky, peri-umbilical abdominal pain that radiates to the back. He also reports nausea and vomiting. Laboratory tests show elevated serum amylase and lipase levels. What is the most likely cause of his abdominal pain?

A 30-year-old female presents with recurrent, colicky abdominal pain and bloating. She also reports changes in bowel habits, with alternating diarrhea and constipation. Physical examination and laboratory tests show no abnormal findings. What is the most likely cause of her abdominal pain?

A 55-year-old male presents with severe, sharp epigastric pain that worsens after meals. He reports significant weight loss and occasional vomiting. Physical examination shows epigastric tenderness. Laboratory tests show anaemia and elevated serum gastrin levels. What is the most likely cause of his abdominal pain?

A 20-year-old female presents with intermittent, crampy lower abdominal pain, bloating, and changes in bowel habits. The pain is relieved with defecation. There are no abnormalities on physical examination, and laboratory tests show no significant findings. What is the most likely cause of her abdominal pain?

A 70-year-old male presents with severe, colicky abdominal pain and distension. He reports constipation for the past few days. On physical examination, there is diffuse abdominal tenderness with no rebound tenderness. An abdominal X-ray shows multiple air-fluid levels. What is the most likely cause of his abdominal pain?

A 60-year-old female presents with recurrent, burning epigastric pain that worsens with an empty stomach and improves with food intake or antacids. She also reports regurgitation and occasional vomiting of sour-tasting contents. Physical examination shows epigastric tenderness. Laboratory tests show elevated serum gastrin levels. What is the most likely cause of her abdominal pain?

A 45-year-old male presents with diffuse abdominal pain, diarrhea, and unintentional weight loss. He also reports a family history of inflammatory bowel disease. Physical examination shows abdominal tenderness, and laboratory tests show elevated inflammatory markers and faecal calprotectin. What is the most likely cause of his abdominal pain?

A 25-year-old male presents with severe, constant epigastric pain that radiates to the back. He also reports nausea and vomiting. Physical examination shows epigastric tenderness, and laboratory tests show elevated serum amylase and lipase levels. What is the most likely cause of his abdominal pain?

A 65-year-old male presents with epigastric pain and bloating after eating fatty meals. Physical examination shows no abnormal findings. Laboratory tests show elevated liver enzymes. What is the most likely cause of his abdominal pain?

A 30-year-old female presents with severe, sharp left lower quadrant abdominal pain, along with fever and elevated white blood cell count. Physical examination shows left lower quadrant tenderness and rebound tenderness. What is the most likely cause of her abdominal pain?

A 40-year-old male presents with recurrent, crampy lower abdominal pain, bloating, and changes in bowel habits. He reports that the pain improves after defecation. Physical examination and laboratory tests show no abnormal findings. What is the most likely cause of his abdominal pain?

A 55-year-old female presents with intermittent, severe upper abdominal pain that worsens after eating fatty meals. She also reports nausea and vomiting. Physical examination shows epigastric tenderness, and laboratory tests show elevated liver enzymes and bilirubin levels. What is the most likely cause of her abdominal pain?

A 30-year-old male presents with severe, diffuse abdominal pain, along with diarrhea and fever. He reports recent travel to a developing country. Physical examination shows abdominal tenderness, and laboratory tests show leucocytosis and stool microscopy positive for white blood cells and parasites. What is the most likely cause of his abdominal pain?

A 25-year-old female presents with severe, lower abdominal pain, along with fever and purulent vaginal discharge. Physical examination shows lower abdominal tenderness. Laboratory tests show elevated inflammatory markers. What is the most likely cause of her abdominal pain?

A 45-year-old male presents with intermittent, crampy left lower quadrant abdominal pain, along with diarrhea and passage of mucus in stools. He also reports unintentional weight loss. Physical examination and laboratory tests show no abnormal findings. The stool shows raised calprotectin. What is the most likely cause of his abdominal pain?

A 60-year-old male presents with severe, crampy abdominal pain, abdominal distention, and vomiting. Physical examination shows hyperactive bowel sounds and abdominal tenderness. Abdominal X-ray shows dilated loops of small bowel with air-fluid levels. What is the most likely cause of his intestinal obstruction?

A 45-year-old female presents with intermittent, colicky abdominal pain, abdominal distention, and constipation. Physical examination shows abdominal tenderness and high-pitched bowel sounds. Abdominal X-ray shows dilated loops of large bowel with a “stepladder” appearance. What is the most likely cause of her intestinal obstruction?

A 35-year-old male presents with acute, severe abdominal pain, abdominal distention, and inability to pass gas or stools. He reports a history of hernia repair surgery several years ago. Physical examination shows abdominal tenderness and high-pitched bowel sounds. Abdominal X-ray shows dilated loops of small bowel with air-fluid levels and a “coffee bean” sign. What is the most likely cause of his intestinal obstruction?

A 25-year-old female presents with abdominal pain, distention, and bilious vomiting. Physical examination shows abdominal tenderness, and laboratory tests show elevated white blood cell count. Abdominal X-ray shows the “double bubble” sign. What is the most likely cause of her intestinal obstruction?

A 50-year-old male presents with abdominal pain, distention, and vomiting. Physical examination shows abdominal tenderness, and laboratory tests show an elevated white blood cell count. Abdominal X-ray shows the “bird beak” sign. What is the most likely cause of his intestinal obstruction?

A 65-year-old female presents with abdominal pain, distention, and constipation. Physical examination shows abdominal tenderness, and laboratory tests show an elevated white blood cell count. Abdominal X-ray shows dilated loops of large bowel with a “coffee bean” sign. What is the most likely cause of her intestinal obstruction?

A 40-year-old male presents with abdominal pain, bloating, and constipation. He reports a history of previous abdominal surgery. Physical examination shows abdominal tenderness, and abdominal X-ray shows dilated loops of small bowel with air-fluid levels. What is the most likely cause of his intestinal obstruction?

A 55-year-old female presents with abdominal pain, distention, and vomiting. Physical examination shows abdominal tenderness, and laboratory tests show an elevated white blood cell count. Abdominal X-ray shows dilated loops of small bowel with a “string of pearls” appearance. What is the most likely cause of her intestinal obstruction?

A 30-year-old male presents with abdominal pain, distention, and inability to pass gas or stools. He reports a history of chronic constipation. Physical examination shows abdominal tenderness, and abdominal X-ray shows dilated loops of large bowel with “haustral markings.” What is the most likely cause of his intestinal obstruction?

A 55-year-old female with a history of alcohol abuse presents with severe abdominal pain, nausea, and vomiting. On physical examination, she appears acutely ill, with epigastric tenderness and distention. Laboratory tests show elevated serum amylase and lipase levels. Abdominal ultrasound shows no evidence of gallstones. What is the most likely cause of her pancreatitis?

A 65-year-old female presents with jaundice, weight loss, and abdominal pain. Physical examination reveals a palpable gallbladder (Courvoisier’s sign). Laboratory tests show elevated bilirubin levels. Abdominal CT scan shows a mass in the head of the pancreas. What is the most likely diagnosis?

A 50-year-old male presents with new-onset diabetes mellitus, unintentional weight loss, and abdominal pain. Physical examination reveals no significant findings. Laboratory tests show elevated blood glucose levels and the presence of diabetes-related autoantibodies. Abdominal CT scan shows a mass in the tail of the pancreas. What is the most likely diagnosis?

A 60-year-old male presents with vague abdominal pain and early satiety. Physical examination reveals no significant findings. Laboratory tests are within normal limits. Abdominal CT scan shows a well-defined lesion in the pancreas with central calcifications. What is the most likely diagnosis?

A 70-year-old female presents with abdominal pain, weight loss, and jaundice. Physical examination reveals a palpable gallbladder (Courvoisier’s sign). Laboratory tests show elevated bilirubin and CA 19-9 levels. Abdominal CT scan shows a mass in the head of the pancreas. What is the most likely diagnosis?

A 55-year-old male with a history of smoking presents with upper abdominal pain that radiates to the back, weight loss, and new-onset diabetes mellitus. Physical examination reveals no significant findings. Laboratory tests show elevated fasting blood glucose levels. Abdominal CT scan shows a mass in the body of the pancreas with dilation of the main pancreatic duct. What is the most likely diagnosis?

A 40-year-old female presents with recurrent abdominal pain, nausea, and bloating. Physical examination reveals tenderness in the epigastric region. Laboratory tests show normal amylase and lipase levels. Abdominal ultrasound shows a multicystic lesion in the pancreas with internal septations. What is the most likely diagnosis?

A 50-year-old male with a history of alcohol abuse presents with upper abdominal pain, weight loss, and steatorrhea. Physical examination reveals no significant findings. Laboratory tests show steatorrhea and elevated faecal elastase-1 levels. Abdominal CT scan shows a small, calcified pancreas. What is the most likely diagnosis?

A 45-year-old female presents with sudden-onset right upper quadrant abdominal pain, fever, and vomiting. On physical examination, she has tenderness and guarding in the right upper quadrant. Laboratory tests show leucocytosis and elevated liver enzymes. Abdominal ultrasound reveals gallbladder wall thickening and pericholecystic fluid. What is the most likely diagnosis?

A 50-year-old male presents with severe right upper quadrant abdominal pain that started after a fatty meal. The pain is radiating to the right shoulder. On physical examination, there is tenderness in the right upper quadrant with a positive Murphy’s sign. Laboratory tests show elevated serum bilirubin and alkaline phosphatase levels. Abdominal ultrasound reveals gallstones and a thickened gallbladder wall. What is the most likely diagnosis?

A 35-year-old female presents with right upper quadrant abdominal pain and bloating. On physical examination, she has tenderness in the right upper quadrant and a positive Murphy’s sign. Laboratory tests show normal liver enzymes and bilirubin levels. Abdominal ultrasound reveals gallstones without evidence of gallbladder wall thickening or pericholecystic fluid. What is the most likely diagnosis?

A 60-year-old male with a history of gallstones presents with severe right upper quadrant abdominal pain, fever, and jaundice. On physical examination, he has tenderness and guarding in the right upper quadrant. Laboratory tests show leucocytosis, elevated liver enzymes, and elevated serum bilirubin levels. Abdominal ultrasound reveals gallstones and a dilated common bile duct. What is the most likely diagnosis?

A 70-year-old female presents with right upper quadrant abdominal pain and a low-grade fever. On physical examination, there is tenderness in the right upper quadrant with a positive Murphy’s sign. Laboratory tests show elevated white blood cell count and C-reactive protein levels. Abdominal ultrasound reveals a thickened gallbladder wall and a pericholecystic fluid collection. What is the most likely diagnosis?

A 25-year-old male presents with acute-onset right lower quadrant abdominal pain that started around the umbilicus and has migrated to the right lower quadrant. On physical examination, there is tenderness and rebound tenderness in the right lower quadrant. Laboratory tests show elevated white blood cell count and neutrophilic leucocytosis. What is the most likely diagnosis?

A 30-year-old female presents with right lower quadrant abdominal pain, nausea, and vomiting. On physical examination, there is tenderness in the right lower quadrant with a positive psoas sign. Laboratory tests show elevated white blood cell count and neutrophilic leucocytosis. What is the most likely diagnosis?

A 20-year-old female presents with right lower quadrant abdominal pain, fever, and elevated heart rate. On physical examination, there is tenderness, rebound tenderness, and guarding in the right lower quadrant. Laboratory tests show elevated white blood cell count and neutrophilic leucocytosis. Abdominal CT scan reveals inflammation of the appendix with an appendicolith. What is the most likely diagnosis?

A 65-year-old male presents with left lower quadrant abdominal pain, fever, and leucocytosis. On physical examination, there is tenderness and localized guarding in the left lower quadrant. Laboratory tests show elevated white blood cell count and C-reactive protein levels. Abdominal CT scan reveals colonic diverticula with peri colonic fat stranding and an inflammatory mass. What is the most likely diagnosis?

A 50-year-old male with a history of diabetes mellitus presents with right upper quadrant abdominal pain, fever, and chills. On physical examination, there is tenderness in the right upper quadrant and hepatomegaly. Laboratory tests show elevated white blood cell count and a markedly elevated alkaline phosphatase level. Abdominal ultrasound reveals a solitary fluid-filled lesion in the liver with internal echoes. What is the most likely diagnosis?

A 40-year-old female with a history of intravenous drug use presents with right upper quadrant abdominal pain, fever, and jaundice. On physical examination, there is tenderness and hepatomegaly. Laboratory tests show elevated white blood cell count, elevated liver enzymes, and elevated bilirubin levels. Abdominal ultrasound reveals multiple fluid-filled lesions with internal echoes in the liver. What is the most likely diagnosis?

A 55-year-old male with a history of alcohol abuse presents with right upper quadrant abdominal pain, fever, and weight loss. On physical examination, there is tenderness and hepatomegaly. Laboratory tests show elevated white blood cell count, elevated liver enzymes, and elevated bilirubin levels. Abdominal CT scan reveals a solitary hypodense lesion with peripheral enhancement in the liver. What is the most likely diagnosis?

A 60-year-old male with a history of chronic hepatitis B presents with right upper quadrant abdominal pain, fever, and jaundice. On physical examination, there is tenderness and hepatomegaly. Laboratory tests show elevated white blood cell count, elevated liver enzymes, and elevated bilirubin levels. Abdominal ultrasound reveals a solitary mass with irregular borders in the liver. What is the most likely diagnosis?

A 45-year-old male with a history of intravenous drug use presents with right upper quadrant abdominal pain, fever, and weight loss. On physical examination, there is tenderness and hepatomegaly. Laboratory tests show elevated white blood cell count, elevated liver enzymes, and elevated bilirubin levels. Abdominal CT scan reveals multiple hypodense lesions with peripheral enhancement in the liver. What is the most likely diagnosis?

A 35-year-old male presents with fatigue, jaundice, and dark urine. Laboratory tests show elevated liver enzymes, elevated bilirubin levels, and the presence of Hepatitis B surface antigen (HBsAg). Hepatitis B envelope antigen (HBeAg) is also detected in the serum. What is the most likely stage of Hepatitis B infection in this patient?

A 28-year-old pregnant female is found to be positive for Hepatitis B surface antigen (HBsAg) during routine prenatal screening. She has no prior history of Hepatitis B vaccination. What is the most appropriate management for this patient?

A 42-year-old male with a history of chronic Hepatitis B presents with worsening jaundice, ascites, and hepatic encephalopathy. His liver function tests show elevated bilirubin levels, elevated liver enzymes, and prolonged prothrombin time. What is the most likely complication of chronic Hepatitis B in this patient?

A 24-year-old female presents with complaints of fatigue, nausea, and joint pain for the past two months. On physical examination, she has hepatomegaly and icteric sclera. Laboratory tests show elevated liver enzymes, elevated bilirubin levels, and the presence of Hepatitis B surface antigen (HBsAg). Antibodies against Hepatitis B core antigen (anti-HBc) are also detected in the serum. Hepatitis B envelope antigen (HBeAg) is negative. What is the most likely stage of Hepatitis B infection in this patient?

A 62-year-old male with a history of chronic Hepatitis B presents with abdominal distension and leg swelling. On physical examination, he has ascites, dilated abdominal veins, and palmar erythema. Laboratory tests show hypoalbuminemia and elevated liver enzymes. Abdominal ultrasound reveals evidence of portal hypertension. What is the most likely cause of portal hypertension in this patient?

A 45-year-old male with a history of intravenous drug use presents with fatigue, anorexia, and right upper quadrant abdominal pain. On physical examination, there is tenderness in the right upper quadrant, and hepatomegaly is noted. Laboratory tests show elevated liver enzymes and elevated bilirubin levels. Serologic testing reveals the presence of antibodies against Hepatitis C virus (HCV). What is the most appropriate next step in the management of this patient?

A 58-year-old female is found to be positive for Hepatitis C antibodies during routine health screening. Laboratory tests show detectable HCV RNA in the blood. What is the most appropriate next step in the management of this patient?

A 30-year-old male with a history of intravenous drug use presents with fatigue, abdominal pain, and jaundice. On physical examination, there is tenderness in the right upper quadrant, and hepatomegaly is noted. Laboratory tests show elevated liver enzymes, elevated bilirubin levels, and detectable HCV RNA in the blood. Serologic testing reveals the presence of antibodies against Hepatitis C virus (HCV). What is the most likely diagnosis?

A 50-year-old male with a history of chronic Hepatitis C infection presents for follow-up. He has been on direct-acting antiviral (DAA) therapy and achieved sustained virologic response (SVR). What is the most appropriate management for this patient at this time?

A 60-year-old female with a history of chronic Hepatitis C infection presents for follow-up. She has been on direct-acting antiviral (DAA) therapy and achieved sustained virologic response (SVR). On examination, she has spider angiomas, palmar erythema, and gynecomastia. Laboratory tests show elevated liver enzymes, elevated bilirubin levels, and low platelet count. Abdominal ultrasound reveals evidence of portal hypertension. What is the most likely complication of chronic Hepatitis C in this patient?

A 38-year-old male with a history of chronic Hepatitis C infection presents for follow-up. He has been on direct-acting antiviral (DAA) therapy and achieved sustained virologic response (SVR). On examination, he has mild palmar erythema and spider angiomas. Laboratory tests show elevated liver enzymes and elevated bilirubin levels. Abdominal ultrasound reveals evidence of hepatomegaly. What is the most appropriate recommendation for this patient at this time?

A 60-year-old male with a history of chronic Hepatitis B infection and cirrhosis presents with right upper quadrant pain and unintentional weight loss. On physical examination, there is hepatomegaly, and a palpable abdominal mass is noted. Laboratory tests show elevated liver enzymes and elevated alpha-fetoprotein (AFP) levels. Abdominal ultrasound reveals a large liver mass with arterial hypervascularity and washout in the venous phase. What is the most likely diagnosis?

A 55-year-old female with a history of non-alcoholic fatty liver disease and type 2 diabetes presents with fatigue and jaundice. On physical examination, there is hepatomegaly and icteric sclerae. Laboratory tests show elevated liver enzymes, elevated bilirubin levels (both direct and indirect), and elevated alpha-fetoprotein (AFP) levels. Abdominal ultrasound reveals multiple liver masses. What is the most likely diagnosis?

A 62-year-old male with a history of chronic Hepatitis C infection and cirrhosis presents for follow-up. On physical examination, there is hepatomegaly and ascites. Laboratory tests show elevated liver enzymes and elevated alpha-fetoprotein (AFP) levels. Abdominal ultrasound reveals a liver mass with irregular borders and areas of necrosis. Biopsy of the liver mass confirms hepatocellular carcinoma (HCC). What is the most appropriate next step in the management of this patient?

A 68-year-old male with a history of chronic Hepatitis B infection and cirrhosis presents with unintentional weight loss, fatigue, and right upper quadrant pain. On physical examination, there is hepatomegaly, and a liver mass is palpable. Laboratory tests show elevated liver enzymes and elevated alpha-fetoprotein (AFP) levels. Abdominal ultrasound reveals a large liver mass with arterial hypervascularity and washout in the venous phase. What is the most appropriate diagnostic procedure to further evaluate this liver mass?

A 50-year-old female with a history of chronic Hepatitis B infection and cirrhosis presents with fatigue and abdominal discomfort. On physical examination, there is hepatomegaly and mild jaundice. Laboratory tests show elevated liver enzymes and elevated alpha-fetoprotein (AFP) levels. Abdominal ultrasound reveals a liver mass with irregular borders and areas of necrosis. Percutaneous biopsy of the liver mass confirms hepatocellular carcinoma (HCC). What is the most appropriate next step in the management of this patient?

A 65-year-old male with a history of alcoholic cirrhosis presents with jaundice, abdominal pain, and unintentional weight loss. On physical examination, there is hepatomegaly and ascites. Laboratory tests show elevated liver enzymes, elevated bilirubin levels (both direct and indirect), and elevated alpha-fetoprotein (AFP) levels. Abdominal ultrasound reveals a liver mass with irregular borders and arterial hypervascularity. Percutaneous biopsy of the liver mass confirms hepatocellular carcinoma (HCC). What is the most appropriate next step in the management of this patient?

Which of the following is the most common cause of liver cirrhosis worldwide?

A 45-year-old female presents with features of liver cirrhosis, including ascites, hepatomegaly, and jaundice. She denies any history of alcohol consumption. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. What is the most likely cause of this patient’s liver cirrhosis?

A 40-year-old male presents with liver cirrhosis and a history of multiple blood transfusions due to thalassemia major. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. What is the most likely cause of this patient’s liver cirrhosis?

A 52-year-old female with a history of obesity and type 2 diabetes mellitus presents with features of liver cirrhosis, including hepatomegaly, jaundice, and oedema. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. She denies any history of alcohol consumption or viral hepatitis. What is the most likely cause of this patient’s liver cirrhosis?

A 64-year-old male with a history of chronic alcohol consumption presents with features of liver cirrhosis, including ascites, spider angiomas, and palmar erythema. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. What is the most significant risk factor for the development of liver cirrhosis in this patient?

A 50-year-old female presents with features of liver cirrhosis, including hepatomegaly, jaundice, and hepatic encephalopathy. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. The patient denies any history of alcohol consumption or viral hepatitis. She has a family history of liver disease, with her brother diagnosed with liver cirrhosis at a young age. What is the most likely cause of this patient’s liver cirrhosis?

A 62-year-old male with a history of chronic alcohol consumption presents with features of liver cirrhosis, including ascites, hepatomegaly, and hepatic encephalopathy. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. The patient is at increased risk of developing hepatocellular carcinoma (HCC) due to cirrhosis. Which of the following risk factors contributes most significantly to the development of HCC in this patient?

A 70-year-old male with a history of chronic viral hepatitis B presents with features of liver cirrhosis, including ascites, hepatomegaly, and jaundice. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. Despite medical management, the patient’s condition worsens, and he develops severe liver failure. What is the most appropriate management option for this patient?

A 59-year-old male with a history of chronic viral hepatitis C presents with features of liver cirrhosis, including ascites, hepatomegaly, and jaundice. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. The patient’s liver biopsy shows regenerating hepatocytes surrounded by fibrous tissue and distortion of the normal liver architecture. What is the most appropriate classification of liver cirrhosis in this patient?

A 45-year-old male with a history of intravenous drug use presents with features of liver cirrhosis, including ascites, hepatomegaly, and jaundice. Laboratory tests show elevated liver enzymes, low platelet count, and prolonged prothrombin time. Abdominal ultrasound reveals a nodular liver with signs of portal hypertension. The patient’s liver biopsy shows large regenerating hepatocytes with surrounding fibrosis and nodules of hepatocytes separated by bands of fibrous tissue. What is the most appropriate classification of liver cirrhosis in this patient?

A 60-year-old male with a history of alcoholic liver cirrhosis presents with new-onset hematemesis (vomiting of blood) and melena (black, tarry stools). He is hypotensive and tachycardic on examination. Laboratory tests show a low haemoglobin level. What is the most likely cause of the gastrointestinal bleeding in this patient?

A 52-year-old female with a history of non-alcoholic fatty liver disease (NAFLD)-related cirrhosis presents with worsening ascites and abdominal distension. On examination, a fluid wave is present. Laboratory tests show a low serum albumin level. Abdominal paracentesis reveals an ascitic fluid albumin level lower than serum albumin. What is the most likely cause of this patient’s ascites?

A 65-year-old male with a history of chronic viral hepatitis B-related cirrhosis presents with confusion and altered mental status. On examination, he has asterixis (flapping tremor of the hands). Laboratory tests show elevated serum ammonia levels. What is the most likely cause of his neurological symptoms?

A 54-year-old male with a history of alcoholic liver cirrhosis presents with increasing abdominal distension and difficulty breathing. On examination, he has prominent distended veins on the anterior abdominal wall. An ultrasound of the abdomen shows ascites, and the hepatic vein Doppler reveals reversed flow during inspiration. What is the most likely cause of this patient’s respiratory distress?

A 63-year-old male with a history of hepatitis C-related cirrhosis presents with fatigue, abdominal pain, and fever. Laboratory tests show elevated liver enzymes and leucocytosis. An abdominal CT scan reveals a hypodense lesion in the liver consistent with an abscess. Blood cultures grow Escherichia coli. What is the most likely cause of the liver abscess in this patient?

A 57-year-old female with a history of alcoholic liver cirrhosis presents with progressive jaundice, abdominal pain, and pruritus. Laboratory tests show elevated serum bilirubin levels, elevated liver enzymes, and elevated alkaline phosphatase. Abdominal ultrasound reveals intrahepatic biliary dilation. What is the most likely cause of this patient’s symptoms?

A 55-year-old male with a history of non-alcoholic steatohepatitis (NASH)-related cirrhosis presents with confusion, lethargy, and fluid retention. On examination, he has marked bilateral lower-extremity oedema and ascites. Laboratory tests show low serum sodium levels and high urine sodium levels. What is the most likely cause of the patient’s hyponatremia?

A 45-year-old obese female presents with elevated liver enzymes on routine blood tests. She denies any history of alcohol consumption. Physical examination reveals hepatomegaly. Laboratory investigations show elevated liver enzymes, elevated triglycerides, and fasting hyperglycaemia. Abdominal ultrasound reveals hepatic steatosis. What is the most likely diagnosis?

A 50-year-old male with a history of type 2 diabetes and hypertension presents with fatigue and right upper quadrant abdominal pain. Laboratory tests show elevated liver enzymes, elevated fasting glucose, and haemoglobin A1c of 9.2%. Abdominal ultrasound reveals hepatic steatosis. What is the most appropriate management for this patient?

A 55-year-old female with a history of obesity, type 2 diabetes, and hyperlipidaemia presents with elevated liver enzymes on routine blood tests. She denies any history of alcohol consumption. Physical examination reveals hepatomegaly. Laboratory investigations show elevated liver enzymes and mild elevation in bilirubin. Abdominal ultrasound reveals hepatic steatosis. What is the next appropriate step in the evaluation of this patient?

A 42-year-old male with a history of non-alcoholic fatty liver disease (NAFLD) presents with right upper quadrant abdominal pain, fever, and jaundice. Laboratory tests show elevated liver enzymes and total bilirubin. Abdominal ultrasound reveals gallstones and mild hepatic steatosis. What is the most likely cause of his current presentation?

A 60-year-old male with a history of non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes presents with progressive jaundice and weight loss. Physical examination reveals hepatomegaly and signs of cirrhosis. Laboratory tests show elevated liver enzymes and total bilirubin, and an elevated alpha-fetoprotein (AFP) level. Abdominal ultrasound reveals liver nodules consistent with hepatocellular carcinoma. What is the most appropriate next step in the management of this patient?

A 45-year-old male presents with fatigue, joint pain, and abdominal discomfort. Physical examination reveals hepatomegaly and bronze pigmentation of the skin. Laboratory tests show elevated liver enzymes, increased serum ferritin levels, and elevated transferrin saturation. Genetic testing confirms the presence of the HFE gene mutation. What is the most likely diagnosis?

A 50-year-old female presents with weakness, joint pain, and palpitations. Physical examination reveals pallor, tachycardia, and systolic murmurs. Laboratory tests show low haemoglobin and haematocrit levels, increased serum iron levels, and low total iron-binding capacity. Iron staining of the liver biopsy shows excessive iron deposition. What is the most likely diagnosis?

A 60-year-old male with a history of hemochromatosis presents with abdominal pain, nausea, and vomiting. Physical examination reveals hepatomegaly and tenderness over the right upper quadrant. Laboratory tests show elevated liver enzymes, elevated serum bilirubin, and increased serum ferritin levels. Abdominal ultrasound reveals gallstones. What is the most likely cause of the patient’s current symptoms?

A 55-year-old male with a history of untreated hemochromatosis presents with progressive liver dysfunction and signs of cirrhosis. Laboratory tests show hypoalbuminemia, prolonged prothrombin time, elevated liver enzymes, and low platelet count. Abdominal ultrasound reveals a nodular liver surface and splenomegaly. What is the most appropriate screening test to detect hepatocellular carcinoma in this patient?

A 30-year-old female presents with joint pain, skin pigmentation, and fatigue. Physical examination reveals hepatomegaly and bronze pigmentation of the skin. Laboratory tests show elevated liver enzymes, increased serum ferritin levels, and elevated transferrin saturation. Genetic testing confirms the presence of the HFE gene mutation. What is the most appropriate management for this patient?

A 35-year-old male with a history of hereditary hemochromatosis presents with recurrent episodes of abdominal pain and dark-coloured urine. Physical examination reveals hepatomegaly and signs of cirrhosis. Laboratory tests show elevated liver enzymes, increased serum bilirubin, and evidence of haemolysis. Abdominal ultrasound reveals gallstones. What is the most likely cause of the patient’s current symptoms?

A 50-year-old male with a history of hereditary hemochromatosis presents with progressive abdominal distension, lower extremity oedema, and ascites. Physical examination reveals hepatomegaly and signs of portal hypertension. Laboratory tests show low platelet count and elevated liver enzymes. Abdominal ultrasound reveals a nodular liver surface and splenomegaly. What is the most likely complication of hemochromatosis in this patient?

A 60-year-old female with a history of hereditary hemochromatosis presents with significant weight loss, fatigue, and anorexia. Physical examination reveals hepatomegaly and signs of cachexia. Laboratory tests show elevated liver enzymes, elevated alkaline phosphatase, and increased serum ferritin levels. Abdominal ultrasound reveals multiple hypoechoic lesions in the liver. What is the most likely complication of hemochromatosis in this patient?

A 40-year-old male with a history of hereditary hemochromatosis presents with shortness of breath and peripheral oedema. Physical examination reveals hepatomegaly, jugular venous distension, and bilateral crackles on lung auscultation. Laboratory tests show elevated liver enzymes and elevated brain natriuretic peptide (BNP) levels. Chest X-ray shows cardiomegaly and pulmonary congestion. What is the most likely complication of hemochromatosis in this patient?

A 55-year-old male with a history of hereditary hemochromatosis presents with a painful and swollen left knee. Physical examination reveals warmth, redness, and effusion in the left knee joint. Laboratory tests show elevated serum ferritin levels and increased C-reactive protein (CRP) levels. Knee joint aspiration reveals hemosiderin-laden macrophages. What is the most likely complication of hemochromatosis in this patient?

A 45-year-old male with a history of hereditary hemochromatosis presents for follow-up. He has been undergoing therapeutic venesection (phlebotomy) to manage his iron overload. His serum ferritin levels have decreased significantly since the initiation of therapy. What is the most appropriate next step in the management of this patient?

A 50-year-old female with hereditary hemochromatosis has been undergoing regular therapeutic venesection (phlebotomy) for the management of her iron overload. She now presents with fatigue and weakness. Laboratory tests show low haemoglobin levels and decreased serum ferritin levels. What is the most appropriate next step in the management of this patient?

A 60-year-old male with a history of hereditary hemochromatosis has been undergoing therapeutic venesection (phlebotomy) to manage his iron overload successfully. He now presents with arthralgia and joint stiffness. Physical examination reveals swelling and tenderness in the metacarpophalangeal joints and proximal interphalangeal joints. X-ray of the hands shows joint space narrowing and periarticular erosions. What is the most appropriate next step in the management of this patient’s joint symptoms?

A 20-year-old male presents with unexplained hepatomegaly, Kayser-Fleischer rings, and neurological symptoms, including tremors and dysarthria. Laboratory tests show low serum ceruloplasmin levels and elevated 24-hour urinary copper excretion. What is the most likely diagnosis?

A 30-year-old male with Wilson’s disease is started on zinc acetate therapy. What is the mechanism of action of zinc in the treatment of Wilson’s disease?

A 40-year-old female with Wilson’s disease presents with worsening neurological symptoms despite being on trientine therapy. Her serum ceruloplasmin levels are still low, and 24-hour urinary copper excretion remains elevated. The patient is experiencing neurological deterioration with dysarthria, dystonia, and tremors. What is the most appropriate next step in the management of this patient?

A 50-year-old male with Wilson’s disease presents with severe haemolysis and anaemia. Laboratory tests show elevated unconjugated bilirubin and low haptoglobin levels. Peripheral blood smear reveals red blood cell fragmentation (schistocytes). What is the most likely explanation for the haemolysis in this patient?