Results for “liver”
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A 58-year-old woman presents with tiredness, a sore tongue and difficulty judging the position of her feet in the dark. She has a macrocytic anaemia, a low seru…
Haematology and Oncology · Clinical rotations · common
A 19-day-old girl is reviewed for jaundice that has persisted since discharge from hospital. Her mother reports that the urine has stained the nappy dark and th…
Paediatrics · Clinical rotations · common
A 3-week-old boy is brought with persistent jaundice, poor weight gain and two episodes of jitteriness before feeds. He was born at term with a small penis and…
Paediatrics · Clinical rotations · middle twist
An otherwise well 29-year-old woman presents eight days after an uncomplicated vaginal delivery with a headache that has gradually intensified over four days. I…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 26-year-old man is referred for recurrent episodes of yellowing of the eyes, usually after intercurrent illness. He has no pruritus, abdominal pain or weight…
Gastroenterology and Hepatology · Mechanisms of disease · niche
A 32-year-old woman at 34 weeks gestation reports two weeks of intense itching that is worse at night and began on her hands and feet. She has no rash, abdomina…
Obstetrics and Gynaecology · Clinical rotations · common
A 47-year-old woman has fatigue, pruritus and intermittent jaundice. Alanine aminotransferase is 680 U/L (5–40), IgG is 31 g/L (7–16), antinuclear and smooth-mu…
Gastroenterology and Hepatology · Clinical rotations · common
A 29-year-old woman is admitted with nausea, jaundice and right upper-quadrant discomfort. Her alanine aminotransferase is 9200 U/L (5–40), aspartate aminotrans…
Cardiovascular · Clinical rotations · middle twist
A 42-year-old man presents with several months of pruritus followed by yellowing of the eyes. He has ulcerative colitis, an alkaline phosphatase of 680 U/L (30–…
Gastroenterology and Hepatology · Clinical rotations · common
A 28-year-old man with type 1 diabetes uses a continuous subcutaneous insulin infusion. He develops nausea after the pump gives an occlusion alarm; his blood gl…
Endocrine and Metabolic · Clinical rotations · common
A 31-year-old woman with type 1 diabetes is being treated for diabetic ketoacidosis with intravenous insulin and 0.9% sodium chloride. Four hours later, her blo…
Endocrine and Metabolic · Clinical rotations · common
A 74-year-old woman with severe chronic obstructive pulmonary disease presents with increasing dyspnoea and drowsiness during a respiratory infection. On room a…
Respiratory · Clinical rotations · common
A 34-year-old woman with asthma remains breathless in the emergency department after three nebulised doses of salbutamol and ipratropium and intravenous hydroco…
Respiratory · Clinical rotations · common
A 67-year-old man with alcohol dependence has mild withdrawal 10 hours after his last drink, with anxiety, tremor and nausea but no hallucinations or seizure. H…
Gastroenterology and Hepatology · Mechanisms of disease · middle twist
A 46-year-old man with longstanding alcohol dependence has eaten little during two weeks of vomiting. He is inattentive, walks with a broad-based gait and repea…
General Practice and Population Health · Clinical rotations · common
A 33-year-old woman at 33+5 weeks has a blood pressure of 168/112 mmHg on two occasions despite oral treatment. She has persistent right upper quadrant pain; pl…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 24-year-old woman presents 30 hours after taking repeated doses of paracetamol for a dental infection. She estimates taking 10–12 g daily for four days; her p…
Emergency and Toxicology · Clinical rotations · common
A 78-year-old man presents with an anterior ST-elevation myocardial infarction at a hospital where primary percutaneous coronary intervention cannot be delivere…
Cardiovascular · Clinical rotations · middle twist
A 31-year-old woman developed a proximal deep vein thrombosis at 32 weeks gestation and has received therapeutic low-molecular-weight heparin since diagnosis. S…
Obstetrics and Gynaecology · Clinical rotations · common
A 74-year-old man reports several months of fatigue and burning of his feet. He has a smooth, sore tongue and impaired vibration sense at both ankles. His haemo…
AMC · Clinical rotations · common