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8 Cards in this Set

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Key History -
Melena vs. bright blood
amount
duration

associated Sxs -
constitutional
abdom pain
rectal pain
tenesmus
constipation/diarrhea

trauma
prior h/o similar Sxs
prior colonoscopy
medications - esp. warfarin
h/o easy bleeding
atherosclerotic vas disease
Key PE -
VS
orthostatics
abdom exam
rectal exam
67 y/o M
presents with blood in stool,
weight loss, constipation
family h/o colon cancer

What is Differential?
Colorectal cancer

anal fissure
hemorrhoids
diverticulosis
ischemic bowel disease
angiodysplasia
upper GI bleeding
IBD
67 y/o M
presents with blood in stool,
weight loss, constipation
family h/o colon cancer

What is Workup?
Rectal exam
CBC, PT/PTT
AST/ALT/bilirubin/alk phos
CEA
colonoscopy
CT - abdo/pelvis
barium enema
33 y/o F
presents with rectal bleeding
and diarrhea
for the past week
lwr abdom pain and tenesmus
for several months

What is Differential?
UC

Crohn's
proctitis
anal fissure
hemorrhoids
diverticulosis
dysentery
33 y/o F
presents with rectal bleeding
and diarrhea
for the past week
lwr abdom pain and tenesmus
for several months

What is Workup?
Rectal exam
CBC, PT/PTT
AXR
colonoscopy
CT - abdo/pelvis
barium enema
58 y/o M
presents with BRBPR and
chronic constipation.
He consumes low-fiber diet.

What is Differential?
Diverticulosis

anal fissure
hemorrhoids
angiodysplasia
colorectal cancer
58 y/o M
presents with BRBPR and
chronic constipation
he consumes low-fiber diet

What is Workup?
Rectal exam
CBC, PT/PTT
electrolytes
colonoscopy
CT - abdo/pelvis