Differential & Work-up: Upper GI bleed, Blood in Stool Flashcards

1
Q

45 yo F presents with coffee-ground emesis for the past 3 days. Her stool is dark and tarry. She has a history of intermittent epigastric pain that is relieved by food and antacids.

A
  1. Bleeding peptic ulcer
  2. Gastritis
  3. Gastric cancer
  4. Esophageal varices
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2
Q

WORK UP FOR:

  1. Bleeding peptic ulcer
  2. Gastritis
  3. Gastric cancer
  4. Esophageal varices
A
  1. Upper endoscopy (including H pylori testing if ulcer is confirmed)
  2. CBC, type & cross
  3. CMP
  4. AST/ALT /bilirubin/ alkaline phosphatase
  5. INR
  6. Rectal exam, stool guaiac &testing
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3
Q

40 yo F presents with epigastric pain and coffee-ground emesis. She has a history of rheumatoid arthritis that has been treated with NSAIDs. She is an alcoholic.

A
  1. Gastritis
  2. Bleeding peptic ulcer
  3. Mallory Weiss tear
  4. Esophageal varices
  5. Gastric cancer
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4
Q

WORK UP FOR:

  1. Gastritis
  2. Bleeding peptic ulcer
  3. Mallory Weiss tear
  4. Esophageal varices
  5. Gastric cancer
A
  1. Upper endoscopy (including H pylori testing if ulcer is confirmed)
  2. CBC, type & cross
  3. CMP
  4. AST/ALT /bilirubin/alkaline phosphatase
  5. INR
  6. Stool guaiac testing
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5
Q

67 yo M presents with blood in his stool, weight loss, and constipation. He has a family history of colon cancer.

A
  1. Colorectal cancer
  2. Diverticulosis
  3. Hemorrhoids
  4. Anal fissure
  5. Angiodysplasia
  6. Upper GI bleeding
  7. Inflammatory bowel disease
  8. Ischemic bowel disease
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6
Q

WORK UP FOR:

  1. Colorectal cancer
  2. Diverticulosis
  3. Hemorrhoids
  4. Anal fissure
  5. Angiodysplasia
  6. Upper GI bleeding
  7. Inflammatory bowel disease
  8. Ischemic bowel disease
A
  1. Colonoscopy
  2. Rectal exam with stool guaiac testing
  3. CT -abdomen/pelvis
  4. CBC,CMP
  5. AST/ALT /bilirubin/alkaline phosphatase
  6. PT/PTT
  7. CEA
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7
Q

33 yo F presents with rectal bleeding and diarrhea for the past week. She has had lower abdominal pain and tenesmus for several months.

A
  1. Ulcerative colitis
  2. Crohn disease
  3. Hemorrhoids
  4. Anal fissure
  5. Proctitis
  6. Diverticulosis
  7. Dysentery
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8
Q

WORK UP FOR:

  1. Ulcerative colitis
  2. Crohn disease
  3. Hemorrhoids
  4. Anal fissure
  5. Proctitis
  6. Diverticulosis
  7. Dysentery
A
  1. Colonoscopy
  2. Rectal exam with stool guaiac testing
  3. CT -abdomen/pelvis
  4. CBC,CMP
  5. PT/PTT
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9
Q

58 yo M presents with painless bright red blood per rectum and chronic constipation. He consumes a low fiber diet.

A
  1. Diverticulosis
  2. Hemorrhoids
  3. Anal fissure
  4. Colorectal cancer
  5. Angiodysplasia
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10
Q

WORK UP FOR:

  1. Diverticulosis
  2. Hemorrhoids
  3. Anal fissure
  4. Colorectal cancer
  5. Angiodysplasia
A
  1. CT -abdomen/pelvis
  2. Colonoscopy
  3. Rectal exam with stool guaiac testing
  4. CBC,CMP
  5. PT/PTT
  6. Tagged RBC scan
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