Medical Data Interpretation

CAGE questionnaire A positive response to any of the four questions may indicate someone at risk of alcohol abuse. A positive answer to two or more questions makes the presence of alcohol dependence likely. C     Have you ever felt that you should  C ut down your drinking? A     Have you ever got  A ngry when someone suggested that you should cut down?  G     Do you ever feel  G uilty about your drinking? E     Do you ever need an  E ye-opener in the morning to steady your nerves or get rid of a hangover?           

Sites of abdominal pain and embryological origins • Epigastric:  foregut (stomach, duodenum, liver, pancreas, gallbladder)  • Periumbilical:  midgut (small and large intestines including appendix)  • Suprapubic:  hindgut (rectum and urogenital organs)     

The PABA test is used to detect pancreatic exocrine insufficiency, ie failure of the pancreas to produce sufficient enzymes for complete digestion. The principle behind the test is simple. After fasting overnight, the patient is given a fixed dose of a peptide comprising  N -benzoyl-L-tyrosyl- p a-aminobenzoic acid (NBT-PABA). In a patient with normal pancreatic exocrine function, pancreatic enzymes break down NBT-PABA into the smaller compound PABA, which is then absorbed and excreted in the urine. Normally more than 70% of the dose administered appears in the urine. Less than 70% excretion implies that the exocrine activity of the pancreas is impaired. DON’T FORGET Normally >70% of the oral PABA dose is detected in the urine.