Basic Pathology

Question 1

Shahadath is a 55 year old who comes to his GP complaining of a feeling of tiredness and malaise. Upon examination he appears to have no signs of disease so the GP asks him to come back if things change. 2 weeks later Shahadath comes in looking very yellow and has experienced weight loss. What is his most likely diagnosis?
A) carcinoma of pancreas
B) cholangiocarcinoma
C) Hepato cellular carcinoma
D) Cholangitis 
E) cholecystitis

Answer 1

A) this is the correct answer. Patient has painless jaundice with weight loss, this is head of pancreas carcinoma until proven otherwise (Courvoisers law)
Cholangitis (D) is accompanied by fever, pain (RUQ) and jaundice. Aka charcot’s triad

Question 2

Which of these is not a cause of AKI?
A) Hypovolaemia
B) Unilateral ureteric obstruction 
C) urate crystals within bladder
D) interstitial glomerulonephritis 
E) Diabetic hypertension

Answer 2

A-D are causes of AKI; A) is pre renal B-C are post renal and D is renal, E is a chronic cause of kidney disease

Question 3

An AXR shows slightly distended large bowels where both of the bowel walls can be clearly seen. The small bowel walls are also clearly visible and not distended. Select from the options the most accurate description of the AXR:
A) Crohn's disease
B) Hiatus Hernia
C) Pneumopritoneum 
D) Signoid volvulus 
E) Rigler's sign

Answer 3

C) Pneumoperitoneum is the most accurate, as free air in the peritoneum means that the bowel walls are well defined on an X-Ray
Rigler’s sign is air on an CXR; free bowel gas in chest and abdomen
Crohn’s presents with fingerprinting
Sigmoid volvulus would be large distended bowel in a curled up shape
Hiatus hernia…(read up)