Blood in stool Flashcards Preview

Step 2 CS - Minicases > Blood in stool > Flashcards

Flashcards in Blood in stool Deck (5)
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1
Q

Key history in blood in stool

A
Melena vs. bright red blood
Amount, duration
Other symptoms (constitutional, abdominal or rectal pain, tenesmus, constipation/diarrhea)
Menstrual cycle
Trauma
Past episodes
Prior colonoscopy
Medications (especially blood thinners)
Hx of easy bleeding or atherosclerosis, valvular disease, renal disease, liver disease, alcoholism, AAA repair
FHx of colon cancer
2
Q

Key physical exam in blood in stool

A

Vital signs +/- orthostatics

Abdominal and rectal exams

3
Q

67 yo M with blood in stool, weight loss and constipation

+ FHx of colon cancer

A

Colorectal cancer
Anal fissure
Hemorrhoids

Rectal exam, CBC, AST/ALT/bilirubin/alkaline phosphatase, INR, CEA, colonoscopy, CT - abdomen/pelvis, barium enema

4
Q

33 yo F with rectal bleeding and diarrhea over last week

+ lower abdominal pain and tenesmus for months

A

Ulcerative colitis
Crohn’s disease
Proctitis

Rectal exam, CBC, PT/PTT, colonoscopy, CT - abdomen/pelvis

5
Q

58 yo M with bright red blood per rectum and chronic constipation
+ low-fiber diet

A

Diverticulosis
Anal fissure
Hemorrhoids

Rectal exam, CBC, type and cross, PT/PTT, electrolytes, colonoscopy, tagged RBC scan, CT - abdomen/pelvis