GIT Dr.

Shaf3y

G.I.T. 2013 26 15

case Liver << case jaundice jaundice shrunken liver cirrhosis disturbed conscious level liver hepatic encephalopathy rigidity tenderness abdominal pain spontaneous bacterial peritonitis

rigidity

jaundice tenderness abdominal pain Spontaneous bacterial peritonitis

oliguria hepato-renal syndrome

case G.I.T. stool

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GIT Dr. Shaf3y

steatorrhea diarrhea constipation G.I.T. case

case Male 40 years old, presented to ER by confusion Examination revealed BP: 140 / 60 heart rate : 80 GCS: 7 / 15 With no evidence of lateralization Jaundice jaundice 15 7 << GCS disturbed level of consciousness Hepatic encephalopathy Abdominal distention, tenderness and rigidity spontaneous bacterial peritonitis Shrunken liver What is the provisional diagnosis this is a case of liver cell failure Complicated by hepatic encephalopathy And spontaneous bacterial peritonitis required to confirm your diagnosis investigations Liver function test hepatic encephalopathy Investigations spontaneous bacterial peritonitis Investigations G.I.T.

Liver function test hepatic encephalopathy investigations spontaneous bacterial peritonitis investigations What are the line of treatment in this patient Liver cell failure treatment hepatic encephalopathy treatment

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GIT Dr. Shaf3y

spontaneous bacterial peritonitis treatment

Liver cell failure treatment Just enumeration Without above see before

spontaneous bacterial peritonitis

hepatic encephalopathy

After admission by one day, developed severe hematemesis and melena What the cause of such a case esophageal varices peptic ulcer gastric ulcer Is common liver cell failure Liver liver cell failure hematemesis varices

gastrin

What is the management approach to patient presenting by haematemesis

Approach to a patient presenting by haematemesis portal hypertension causes this may be Esophageal varices 1 Peptic ulcer 2

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GIT Dr. Shaf3y

Male patient 32 years, presented by jaundice with dark urine That develops in few days Liver Jaundice dark urine dark urine obstructive hepatocellular

hemolytic dark on standing Pain in the right hypochondrium Examination revealed enlarged tender liver He notices anorexia toward cigarette smoking What is your provisional diagnosis A case of acute hepatitis What are the investigations acute hepatitis Investigations Mention how the diagnosis may affect the diet of such a patient diet manifestations of liver cell failure Unless

Enumerate the complications of such a disease hepatic extra hepatic acute and chronic hepatic Enumerate the causes of enlarged tender liver Malignant, congestive, infective Female 45 years, presenting by jaundice since one month, which is progressive in nature She also complains of diminution of her vision especially at night night blindness With severe backache and rash Her stool is bulky and offensive She gives history of severe itching since two years jaundice itching Examination revealed swelling in the neck and clubbing
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GIT Dr. Shaf3y

What is your provisional diagnosis Primary biliary cirrhosis auto immune thyroiditis rash ) systemic lupus Primary biliary cirrhosis associated auto immune disorders Systemic lupus Auto immune thyroiditis What are the investigations required to confirm the diagnosis Primary biliary cirrhosis Investigations What is the explanation of the clinical finding in such a case Neck swelling auto immune thyroiditis rash systemic lupus clubbing auto immune

What is the treatment in such a case Primary biliary cirrhosis treatment

haemochromatosis total iron binding capacity 30 % 25 % 70 % 40 % iron

electrolytes endocrine
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case

GIT Dr. Shaf3y

Cushing << Addison << haemochromatosis Liver cirrhosis Addison

liver cell failure Complicated by spontaneous bacterial peritonitis hepato-renal syndrome What are causes of renal impairment in such hepatic patient renal impairment hepato-renal syndrome

glomerulonephritis

Hepatitis

Neomycin hepatic encephalopathy What are the causes of refractory ascites T.B. Malignant Hyponateremia Severe hypoalbuminemia End stage liver disease Spontaneous bacterial peritonitis

Female 33 years old, presenting by severe diarrhea more than 2 months Not responding to anti diarrheal agents She mentioned that the stool is bulky, offensive and greasy examination revealed dermatitis herpetiformis Coeliac disease
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GIT Dr. Shaf3y

Coeliac Investigations Investigations treatment treatment

Male 40 years old, presenting to ER by haematemesis Examination revealed blood pressure 90 / 60 Heart rate : 120 GCS : 7 / 15 With no evidence of lateralization

Female 50 years old, presenting by recurrent attacks of bloody diarrhea And abdominal colic Examination revealed tenderness in the right iliac fossa With anal fissure She gives history of renal colic Since six months Which is thought to be renal stones Examination revealed << SGOT and SGPT alkaline phosphatase X ray shows diffuse reticulation What is your provisional diagnosis This is a case of Crohns disease Complicated by oxlate stones extra hepatic manifestations auto immune hepatitis sclerosing cholangitis alkaline phosphatase interstitial lung fibrosis X ray hepatitis SGPT SGOT Sclerosing cholangitis alkaline phosphatase

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GIT Dr. Shaf3y

acute pancreatitis fat pancreatitis calcium blood vessel

leak

albumin

systemic inflammation

. Male 65 years old, presenting by jaundice pale stool dark urine severe itching 8 << Total bilirubin 6 << Direct

<< MRCP Obstruction of main bile duct What are the most possible diagnosis of such a case cancer

Male patient 55 years old, Chronic liver disease Secondary to hepatitis B Recently he started to deteriorate with progressive and jaundice Investigations 12 bilirubin 18 What is your provisional diagnosis Hepatocellular carcinoma para malignant syndrome polycythemia

G.I.T. 28 2013 26

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GIT Dr. Shaf3y

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