A 46-Year-Old Woman Was Instructed to Follow Up with Her

question 101

Multiple Choice

A 46-year-old woman was instructed to follow up with her primary care physician after a recent emergency department visit for self-limited nausea and vomiting.  The patient currently has no issues.  Her medical history is notable for obesity, ulcerative colitis, essential hypertension, and gastroesophageal reflux disease.  The patient's last ulcerative colitis flare was 5 years ago and was treated with a short course of corticosteroids.  Colonoscopy with biopsy performed a year ago revealed mild inflammation with no dysplasia.  Her medications include mesalamine, omeprazole, and lisinopril.
Blood pressure is 140/88 mm Hg, pulse is 84/min, and respirations are 14/min.  BMI is 32 kg/m².  Cardiopulmonary examination is normal.  The abdomen is soft and nontender.  There is no hepatomegaly or splenomegaly.
Laboratory results from the patient's recent emergency department visit are as follows:
Repeat testing shows similar results.
Which of the following would be the most helpful for establishing the diagnosis in this patient?

• A)Bone scan
• B)Cholangiography
• C)CT scan of the abdomen with contrast
• D)Liver biopsy
• E)Mesalamine discontinuation

---

Definitions:

Crowdsourcing

A technique of acquiring knowledge, thoughts, or content by appealing for contributions from an extensive group of individuals, often through the internet community.

Medical Information

Data related to a person's health or medical condition, treatment, and history, often used for clinical decision-making.

Pharmaceuticals

Refers to medicinal drugs manufactured for sale and use in healthcare.

Crowdfunding

The practice of funding a project or venture by raising small amounts of money from a large number of people, typically through the Internet.