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NICE has strict and clear guidance regarding which adult patients are safe to discharge and which need further CT head imaging. Any sign of basal skull fracture haemotympanum, 'panda' eyes, Battle's sign, CSF fluid leakage from the ear or nose. Post-traumatic seizure. Focal neurological deficit. Battle's sign consists of bruising over the mastoid process, as a result of extravasation of blood along the path of the posterior auricular artery. Battle's sign may be confused with a spreading hematoma from a fracture of the mandibular condyle, which is a less serious injury.

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Venesection is recommended when the serum ferritin reading is over ? Venesection can restore hypothalamic-pituitary-gonadal and can reduce liver fibrosis.

He also gives a history of episodes of flushing. VIP syndrome is considered by the admitting physician. Which one of the following is a feature of VIPoma syndrome?

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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?

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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.

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