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Which one of the following is the most appropriate treatment? Ciprofloxacin would cover for this as well as shigella, salmonella and campylobacter. However, if giardiasis was cultured in the stool then metronidazole is recommended. Over the past 6 months he has lost 2 stones in weight. On examination he has palmar erythema, jaundiced sclerae, spider naevi, hepatomegaly and ascites.
Melanosis coli 1- Hypoglycaemia 2- Hypokalaemia [ Q: 4 ] MRCPass - Gastroenterology 3- Induction of VIP release by somatostatin A 40 year old man has symptoms of lethargy, joint pains and jaundice which have occurred over the past 8 months.
Four years later he became diabetic and was referred to our hospital clinic. He was noted to be pigmented. Haemochromatosis was confirmed by an iron saturation of What is the recommended management?
However, venesection is preferred therapy and desferrioxamine infusion another iron chelator can also be used. Initial treatment is directed toward correcting volume and electrolyte abnormalities by using potassium chloride and sodium bicarbonate.
He complains of fever, rigors and headache.
His abdomen was tender in right upper quadrant. Investigations showed: Hb He has lost 2. Which of the following investigations would be of diagnostic value?
What is the likely diagnosis? Abdominal pain is often a feature of the illness.
Diarrhoea is often associated with blood. The clinical history with associated pleural effusion suggests that an abscess needs to be excluded and drained if necessary. She had a past history of radiotherapy for ovarian cancer.
Small intestine biopsy reveals villous atrophy, crypt Dr. The commonest causes are E coli , but other precipitants are campylobacter, shigella and clostridium. There is classical renal failure, thrombocytopenia HUS-TTP and evidence of microangiopathic haemolysis on the blood film.
He has the following results: Answer: 2- Coeliac disease Histology of small bowel biopsy specimens remains the "gold standard" for diagnosis. Fasting plasma glucose 7.
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Salbutamol is a b2-agonist used in the treatment of asthma. Agonists potentiate the physiological effects of certain receptors, whereas antagonists block those effects.
Another example of antagonism Dr.
Competitive antagonists bind to the site of action for the endogenous receptor ligand and can be displaced, eg prazosin , whereas non-competitive antagonists eg phenoxybenzamine cannot be displaced or have their effects diminished by an endogenous receptor ligand.
A partial agonist eg acebutolol may exhibit strong receptor-binding activity, but a limited physiological response.
She sought your opinion because her other physician was recommending iron supplementation iv. She has been on nearly continuous iron supplementation therapy ever since her second child was born 23 years ago. Over the years she says her doctors have prescribed her to take anywhere from one to three pills daily, sometimes with vitamin C concomitantly.
Although she has never needed a transfusion, she says she has been told that her RBC count has never completely normalized. She is otherwise healthy and has no unusual dietary habits. Her menstrual history reveals relatively normal menstrual periods until about 3 years ago, when she attained menopause. The patient believes that her mother was also iron deficient. Your physical exam is normal.
Laboratory values show a haemoglobin of Deletion of two a-genes results in mild to moderate microcytosis and mild anaemia, rarely with any progression or development of other signs or symptoms.
It is often mistaken for iron deficiency anaemia and menstruating women with the condition are often treated for prolonged periods with iron supplementation because it is presumed that the mild microcytic anaemia is due to iron deficiency. A haemoglobin electrophoresis is a useful test for b-thalassemia wherein one looks for increased levels of haemoglobin A2 and haemoglobin F. However, haemoglobin electrophoresis is generally not helpful for the diagnosis of an athalassemia disorder.
Haemoglobin C disease has an autosomal recessive inheritance and is one of the "benign" haemoglobinopathies, presenting as haemolytic anaemia. Sickle cell disease presents as chronic haemolytic anaemia and vaso-occlusive crisis.