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A 36-year-old man, who had recently moved to the UK from Kashmir, presented to the emergency department with episodic severe right upper-quadrant pain.
Investigations:
Ultrasound abdomen The distal CBD contains several hypoechoic tubular structures with well-defined echogenic walls seen making curling movements.
Which of the following is the most likely cause?
A 36-year-old man, who had recently moved to the UK from Kashmir, presented to the emergency department with episodic severe right upper-quadrant pain. Investigations: Ultrasound abdomen The distal CBD contains several hypoechoic tubular structures with well-defined echogenic walls seen making curling movements. Which of the following is the most likely cause?
What is the 10-year incidence of recurrent PSC after liver transplantation?
What is the 10-year incidence of recurrent PSC after liver transplantation?
A 37-year-old woman with type 1 diabetes mellitus presented to the emergency department with a four-hour history of severe epigastric pain radiating through to the back.
Investigations:
Serum bilirubin 36 µmol/L
Serum alanine aminotransferase (ALT) 152 U/L
Serum alkaline phosphatase (ALP) 168 U/L
Serum albumin 30 g/L
Serum amylase 1,200 U/L
HbA1c 72 mmol/mol
Serum triglycerides 9 mmol/L
Ultrasound abdomen-hyper echogenic foci within gall bladder lumen with acoustic shadow
What is the most likely aetiology of this patient’s acute pancreatitis?
A 37-year-old woman with type 1 diabetes mellitus presented to the emergency department with a four-hour history of severe epigastric pain radiating through to the back. Investigations: Serum bilirubin 36 µmol/L Serum alanine aminotransferase (ALT) 152 U/L Serum alkaline phosphatase (ALP) 168 U/L Serum albumin 30 g/L Serum amylase 1,200 U/L HbA1c 72 mmol/mol Serum triglycerides 9 mmol/L Ultrasound abdomen-hyper echogenic foci within gall bladder lumen with acoustic shadow What is the most likely aetiology of this patient’s acute pancreatitis?
An 8-week- old male infant presents with jaundice. He was born at full term after an uneventful pregnancy. Physical examination reveals a palpable mass in the right upper quadrant. Ultrasound of the abdomen shows diffuse fusiform dilation of the bile duct. What is the preferred management
for this child?
An 8-week- old male infant presents with jaundice. He was born at full term after an uneventful pregnancy. Physical examination reveals a palpable mass in the right upper quadrant. Ultrasound of the abdomen shows diffuse fusiform dilation of the bile duct. What is the preferred management for this child?
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A 12-year old girl with a history of hereditary spherocytosis is found to have gallstones on an ultrasound that was performed to evaluate abdominal pain and abnormal liver enzyme levels. What is the most likely composition of the gallstones?
A 12-year old girl with a history of hereditary spherocytosis is found to have gallstones on an ultrasound that was performed to evaluate abdominal pain and abnormal liver enzyme levels. What is the most likely composition of the gallstones?
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Right upper quadrant ultrasound shows gallbladder stones, no gallbladder wall thickening, and CBD of 7 mm. Which of the following is the most appropriate next step in management?
Right upper quadrant ultrasound shows gallbladder stones, no gallbladder wall thickening, and CBD of 7 mm. Which of the following is the most appropriate next step in management?
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Which of the following is considered a risk factor for cholelithiasis?
Which of the following is considered a risk factor for cholelithiasis?
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Which of the following is a risk factor for the development of gallstones in children?
Which of the following is a risk factor for the development of gallstones in children?
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An 11-year- Old obese girl presents with her parents for chronic abdominal pain. Her pain is in the right upper quadrant
and is postprandial and intermittent. She is not taking any medications. Physical examination reveals no abdominal tenderness.
Laboratory studies, including complete blood count and complete metabolic panel, are normal. Ultrasound of the
abdomen reveals a normal-appearing gallbladder and liver with no gallstones. What is the next step in management?
An 11-year- Old obese girl presents with her parents for chronic abdominal pain. Her pain is in the right upper quadrant and is postprandial and intermittent. She is not taking any medications. Physical examination reveals no abdominal tenderness. Laboratory studies, including complete blood count and complete metabolic panel, are normal. Ultrasound of the abdomen reveals a normal-appearing gallbladder and liver with no gallstones. What is the next step in management?
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A 5-month- old infant is admitted to the hospital with worsening jaundice and abdominal distension of 6 weeks duration.
She also has dark-colored urine and light-colored stool. The infant was a full-term baby delivered by normal vaginal delivery. Vitals signs are as follows:
Temperature 99°F, Heart rate 120 bpm
Respiratory rate 25 breaths/min
Physical examination reveals jaundice, abdominal distension, and no organomegaly. The liver and spleen are not enlarged.
Laboratory values are as follows:
Alanine aminotransferase 15 U/L
Aspartate transaminase 17 U/L
Alkaline phosphatase 250 U/L
Total bilirubin 2.8 mg/dL
Ultrasound reveals no dilation in the bile ducts. Which of the following is the most likely diagnosis?
A 5-month- old infant is admitted to the hospital with worsening jaundice and abdominal distension of 6 weeks duration. She also has dark-colored urine and light-colored stool. The infant was a full-term baby delivered by normal vaginal delivery. Vitals signs are as follows: Temperature 99°F, Heart rate 120 bpm Respiratory rate 25 breaths/min Physical examination reveals jaundice, abdominal distension, and no organomegaly. The liver and spleen are not enlarged. Laboratory values are as follows: Alanine aminotransferase 15 U/L Aspartate transaminase 17 U/L Alkaline phosphatase 250 U/L Total bilirubin 2.8 mg/dL Ultrasound reveals no dilation in the bile ducts. Which of the following is the most likely diagnosis?
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