Practice paper
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Lee, aged 34, presents to the emergency department with sudden onset severe epigastric pain and vomiting. List four causes of acute epigastric pain. (2)Name a radiological investigation you would use in this case in the emergency department. (1)Lee’s amylase comes back as 1340. List three causes of pancreatitis. (3)Lee’s Glasgow score is 3. What implication does this have on his management? (1)List two criteria to calculate a Glasgow score. (1)How would you treat pancreatitis initially? (2)Why would a USS abdomen be useful in this case? (1)On the post-take ward round the next morning, your consultant notices some bruising on the patient’s flank. What is the eponym for this sign and what does it represent? (2)Name two complications of acute pancreatitis. (2)
Bhringraj
Tewari (personal communication, 1979) tried 10 g of whole plant powder three times a day on 35 patients with non-ulcer dyspepsia and 25 patients with peptic ulcer dyspepsia for 3 months. A complete symptomatic relief in epigastric pain, nausea and vomiting was seen. There was a reduction in flatulence and the amount of free gastric acid. Eighty per cent of the patients of non-ulcer dyspepsia responded well, with relief in acid secretion, nocturnal pain, nausea and vomiting. In 48 per cent of patients with duodenal ulcer the results were excellent while in 75 per cent of cases there was radiological improvement. Raut et al. (1986) tried the herb for ulcers and peptic ulcers. Das (1992) studied the effect of the herb on gastritis by administering 12 g of pulverized herb daily, in three divided doses, for 45 days. In 52 per cent of cases of gastritis the results were excellent. In hyperchlorhydria there was total relief.
DRCOG MCQs for Circuit C Questions
Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Features of pre-eclampsia include:Raised BP that develops after 16 weeks' gestation.Blurred vision.Epigastric pain.Hyper-reflexia.Spontaneous bleeding.
Concomitant hypertriglyceridemia-induced pancreatitis in pregnant monozygotic twin siblings
Published in Gynecological Endocrinology, 2020
Yahya Ayhan Acar, Gizem Gunay, Sedat Bilge, Onur Tezel
According to the revised Atlanta classification [6], acute pancreatitis can be diagnosed if at least two of the following three criteria are fulfilled: abdominal pain (acute onset of persistent and severe epigastric pain, often radiating to the back), serum lipase (or amylase) activity at least three times the upper limit of normal, and characteristic findings of acute pancreatitis on contrast-enhanced computed tomography (CT), or (less often) magnetic resonance imaging or trans-abdominal ultrasonography. Both of our cases showed slightly higher serum lipase activity, additional abdominal pain, and ultrasound findings supporting the diagnosis of pancreatitis. Due to pregnancy, abdominal CTs could not be performed. Therefore, epigastric pain should be examined in a detailed manner, and clinical suspicion seems particularly valuable in cases of pregnant women.
Endophthalmitis with retained intraocular foreign body after catgut embedding at periocular acupoints
Published in Clinical and Experimental Optometry, 2022
Xuebin Zhou, Han Chen, Jinling Fu, Lingxian Xu, Chen Chen, Guanfang Su, Chenguang Wang
Acupoint catgut embedding therapy is a stimulation method that was developed from traditional acupuncture therapy. It is based on the key principle of acupuncture in traditional Chinese medicine. Especially, it is based on the belief that organ disorders are reflected at specific points on or near the surface of the skin (acupoints). It is also believed that the stimulation of acupoints can modify the physiology of the body. Acupoint catgut embedding therapy employs sutures made of catgut, collagen, or polymer to apply persistent stimulation during suture absorption.1 This method has been applied extensively in patients with epigastric pain, obesity, low back pain, and leg pain, among others.2 There are reports of the application of catgut embedding at periocular acupoints for the treatment of myopia.3,4 Periocular acupoint catgut embedding is performed by placing 1–2 cm of catgut at the tip of a lumbar puncture needle tube, which is then connected to the needle core after disinfection. The acupuncture penetrates the periocular acupoints to a certain depth, which is usually located in the adipose body of the orbit. The needle core is pushed while the needle tube is withdrawn, and the catgut is embedded in the periocular acupoint.1 This report describes a unique case of a patient with endophthalmitis with a retained intraocular foreign body (IOFB) after an erroneous periocular acupoint catgut embedding.
Immunopathological and molecular basis of functional dyspepsia and current therapeutic approaches
Published in Expert Review of Clinical Immunology, 2018
Mounika Addula, Victoria E. D. Wilson, Savio Reddymasu, Devendra K. Agrawal
As one of the most frequent cases among patients in medical settings, symptoms of FD patients overlap with GERD and gastroparesis [89]. A study of 24-h pH monitoring in patients with heart burn negative FD showed abnormal pH monitoring in 23% of patients. These patients presented with higher prevalence of epigastric pain [90]. Gastric emptying studies can rule out gastroparesis in patients at increased risk, such as diabetics. Symptoms can persist for life, with inconsistent relief. Among patients initially evaluated, if H. pylori is found this may be readily eradicated. Endoscopy is preserved for patients with persistent symptoms despite anti-secretory therapy and H. pylori treatment. It is estimated that more than 1 billion euros are spent in the UK alone with respect to diagnosis and treatment of FD. Impaired gastric accommodation, slow gastric emptying, and increased visceral sensitivity have long been thought of as main causal factors of FD. However, more recent identification of eosinophilic degranulation and recruitment of T cells that induce mild duodenal inflammation are giving rise to new insights into immune-mediated pathophysiology. These insights offer promising avenues to explore immune-mediated therapy in the future.
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