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(solution) A 42 year old man presents to Accident and Emergency Department


A 42 year old man presents to Accident and Emergency Department with a 1 day history of vomiting fresh blood. He also reports the passing of black coloured stool for at least 3 days and feeling generally unwell for almost 6 weeks. his main complaints is of easy fatigue and he's unable to carry on his work beyond 3pm . he is privately employed as a driver and does not fit drink alcohol. his past medical history is uneventful with the exception that he had 3 episodes of jaundice:first when he was 20years old, then 4-5 years after that and a further episode about 3 years ago. Each time he was seen by a herbal practitioner who prescribed some herbs, and after a few days the patient felt better. The main reason for not seeking medical attention was financial constraints as he thought a doctor would order lots of test that he could not afford

a) what would  your differential diagnosis include before examination..

b) what investigation would you carry out

c) what's your diagnosis

d) how do you manage this patient.

 







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