Medplexus

91).  A  64-year-old  patient  has  been  referred  to  planned  hospitalization  for  general  weakness,  poor  appetite,  progressive  jaundice  which  appeared  over  3  weeks  ago  and  wasn’t  accompanied  by  pain  syndrome.  Objectively:  body  temperature  is  at  the  rate  of  36,8oC,Ps-78/min,  abdomen  is  soft  and  painless,  the  symptoms  of  peritoneal  irritation  are  present,  palpation  reveals  a  dramatically   enlarged,  tense gallbladder . What disease are these symptoms typical for? A.Cancer of the pancreatic head B.Duodenal ulcer C.Acute cholecystitis D.Chronic cholecystitis E.Lamblia-induced cholecystitis Explanation :     Elderly is risk factor.  weight  is alarm sign  for cancer.   enlarged,  tense gallbladder due to bile outflow obstruction by pancreatic head cancer. 92).A patient is 31 years old.  Double-contrast barium swallow revealed a filling defect on the posterior  wall in the middle segment of  esophagus . The defect looked like  a  well-de

81). 4 hours after having meals a patient with signs of  malnutrition and steatorrhea  experiences stomach pain, especially above navel and to the left of it. Diarrheas take turns with constipation lasting up to 3-5 days. Palpation reveals moderate painfulness in the choledochopancreatic region. The amylase rate in blood is stable. X-ray reveals some  calcifications  located above navel. What is the most likely diagnosis?  A. Chronic pancreatitis B. Chronic gastroduodenitis C. Duodenal ulcer D. Zollinger-Ellison syndrome E. Chronic calculous cholecystitis Explanation:  Chronic pancreatitis leads to   Deficiency  of  pancreatic  enzyme (lipase) which is essential for   conversion  of triglyceride  to monoglycerides and free fatty acids  which is absorbed. Due to lipase deficiency cause natural fat in stool i.e  steatorrhea . X-ray  reveals  calcifications above naval is  pathognomonic sign.   82). A 51-year-old female patient complains of  frequent defecation and liquid blood

71). 4 hours after having meals a patient with signs of  malnutrition and steatorrhea  experiences stomach pain, especially above navel and to the left of it. Diarrheas take turns with constipation lasting up to 3-5 days. Palpation reveals moderate painfulness in the choledochopancreatic region. The amylase rate in blood is stable. X-ray reveals some calcifications located above navel. What is the most likely diagnosis?  A. Chronic pancreatitis B. Chronic gastroduodenitis C. Duodenal ulcer D. Zollinger-Ellison syndrome E. Chronic calculous cholecystitis Explanation  :steato 72). A 43-year-old female patient complains of  unstable defecation with frequent constipations , abdominal swelling, headache, sleep disturbance. Body  weight is unchanged . What disease are these clinical presentations typical for? A. Irritable colon syndrome B. Chronic enteritis C. Chronic pancreatitis D. Chronic atrophic gastritis E. Colorectal cancer Explanation : Diagnostic C riteria  for Ir