Exam 3 Clinical Vignettes Flashcards
A 21-year-old man is brought to the emergency room with symptoms of acute
intestinal obstruction. Physical examination reveals a mass in the right lower
abdominal quadrant. The patient subsequently undergoes surgery for an
“inflammatory bowel disease”.
Crohn’s Disease
A 44-year-old woman presents with a 2-month history of burning epigastric pain that usually occurs between meals. The pain can be relieved with antacids or food. The patient also reports a recent history of tarry stools (Melena). Labratory studies show anemia. Gastroscopy reveals a bleeding mucosal defect in the antrum measuring 1.5 cm in diameter.
Peptic Ulcer caused by H. Pylori
A 52-year-old woman presents with pruritus (itchy skin). Liver biopsy reveals injury to tintrahepatic biile ducts and cholestaisis. Labratory studies reveal the presence of circulating antimitochondrial antibodies.
Primary Biliary Cirrhosis
A 55- year old woman who suffers from diabetes mellitus and frequent urinary tract infections presents witha 3-day history of flank pain, fever, and general malaise. A complete blood count (cbcO shows neutrophilic. Urine cultures are positive for gram negative microorganisms. Microscopic examination of the urine sediment reveals neutrophils and leukocyte casts, consistent with an upper urinary tract infection.
Acute Pyelonephritis
A 58- year old alcoholic woman is admitted to the emergency department. the patient exhibits signs and symptoms of prottal hypertension secondary to hepatic cirrhosis
Jaundice ascites and esophageal varices
A 59-year old man complains of progressive weakness. His friends hav noticed that he has become pale. He reports that his stools are itnged with lood. On abdominal palpation there is a fullness in the right lower quadrant. Laboratory studies show iron-deficiency anemia. Stool Specimens are positive for occult blood. Colonoscopy reveals an elevated and centrally ulcerative lesion of the sigmoid colon
Colon Cancer (Adenocarcinoma)
A 60-yera-old alcoholic is brought to the emergency room in a comatose state. Physical examination reveals yellow discoloration of the sclera.
Jaundice due to hyperbilirubinemia
A 60-year old man with a history of heavy smoking and alcohol consumption complains that he has difficulty swallowing his food.
Esophageal Cancer (if history of Barrett’s esophagus; Most likely tumor is Adenocarcinoma
A 65-year-old woman presents with an 8-week history of progressive weight loss, nauea and upper abdominal pain. Laborratory studies show iron-deficiency anemia. Grastroscopy reveals a crater-like lesion in the antrum. The patient undergoes partial gastrectomy and histologic examination of the surgical specimen reveals a malignant neoplasm.
Adenocarcinoma of the stomach
A 70-year-old man with sclerosis of the lumbar vertebrai had a rock-hard prostate onn digital rectal examination.
Prostate Adenocarcinoma– Markers include PSA and Alkaline Phosphatase for bone invasion.
A liver biopsy of a 53-year-old man with jaundice reveals evidence of acute alcoholic hepatitis. This biopsy shows neutrophils
Hepatitis that leads to cirrhosis
A testicular tumpor from a 24-year-old man is removed and tissue sections are examined by lifght microscopy. The pathologist observes multinucleated giant cells, reflecting differeniation of trophoblastic stem cells.
Choriocarcinoma (Germ cell malignnt tumor)
A 65-year-old woman has a past medical history of esophageal varices splenomegaly and ascites.
Hepatic Cirrhosis with portal hypertension
The parents of a 2-week-old neonate ask you questions about congenital birth defects that affect the esophagus
Tracheoesophageal fistula and webbing
22-year old ewoman has diffuse inflammation of the superficial lining of the large intestine
Ulcerative Colitis
