By Alissa J. Walsh, Otto C. Buchel, Jane Collier, Simon P.L. Travis
Dependent round the center curriculum for professional trainees in gastroenterology and hepatology, this booklet includes 50 well-structured, peer-reviewed situations collected from the Oxford Hospitals, comprehensively masking a few of the issues of the gastrointestinal system.
Each case includes a short scientific heritage and proper exam findings, info of investigations together with examples of clinical imaging, via questions about differential analysis and administration and certain solutions and dialogue. The textual content is complemented by means of various black and white illustrations, together with radiographic photos, and 24 color photos. The question-and-answer structure is designed to reinforce the reader's diagnostic skill and medical realizing.
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Additional info for Oxford Case Histories in Gastroentrology and Hepatology (Oxford Case Histories)
The role of HIV as a diarrhoeal pathogen remains controversial. HIV enteropathy is a term used to account for diarrhoea in AIDS patients who lack an identifiable cause. Although the precise features are not agreed, the term implies a chronic diarrhoeal illness in patients with AIDS where no cause can be found despite extensive evaluation. With improvement in diagnostic techniques, greater awareness of the spectrum of diarrhoeal pathogens, and endoscopy with small intestinal biopsies in patients with negative stool tests, a diminishing proportion have ‘idiopathic diarrhoea’.
It is clinically associated with improvement in liver enzyme tests, with an initial response evident at 6 weeks. The rapid initial response slows to a steady subsequent improvement. Within 2 years 20% will have normal liver enzymes, which increases to 35% at 5 years. Early histological stages (I and II) may have slower progression on ursodeoxycholic acid, but a significant survival benefit has not yet been shown. The indication for treatment with ursodeoxycholic acid is a positive antimitochondrial antibody with abnormal liver enzymes.
Interestingly, the prevalence of diabetes in patients with haemochromatosis is no different from the general population. A useful clinical tip is to consider haemochromatosis should a patient have liver disease and disease in one other organ (diabetes, cardiac failure etc). Cardiac involvement is much less common and usually manifests as congestive cardiac failure, although arrhythmias may occur. Like pituitary failure, it is more common in the juvenile forms of the disease. 6c) Discuss the types of genetic iron overload.
Oxford Case Histories in Gastroentrology and Hepatology (Oxford Case Histories) by Alissa J. Walsh, Otto C. Buchel, Jane Collier, Simon P.L. Travis