srf
Forum Guru
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To localize the source of hematochezia in a 70-year-old man, which one of the following is the most appropriate sequence of diagnostic tests?
Barium enema, nasogastric intubation, sigmoidoscopy
Nasogastric intubation, colonoscopy, angiography
Rectal examination, angiography, sigmoidoscopy
Colonoscopy, gastroscopy, CT scan of the abdomen
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| achilles
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rectal exam, angiography, sigmoidoscopy
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| Reddoc
Forum Senior
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Nasogastric intubation, colonoscopy, angiography
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| p53
Forum Guru
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Nasogastric intubation, colonoscopy, angiography
actually, it should be upper endoscopy intead of Nasogastric intubation but I think other choices are clearly wrong.
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| chemamr
Moderator and PGY1
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agree with B (NGT, colon, angiog)
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| wyvern
Forum Guru
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B
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| yasmeen
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ONLY B IS REASONABLE
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| mesh
Forum Guru
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B
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| srf
Forum Guru
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Posts: 405
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B
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| amit_k_m
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Can u explain why u think its B...
I think it should be the last one.... Coloscopy, gastroscopy and CT scan..... as this man is 70 yrs old loer GI bleed is more likely. so colonoscopy should be the first followed by gastroscopy as upper GI blees may also present as hematochezia. finally CT.
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| amit_k_m
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Helical CT scan of the abdomen and pelvis can also be used when routine workup fails to determine the cause of active GI bleeding. Multiple criteria including vascular extravasation of the contrast medium, contrast enhancement of the bowel wall, thickening of the bowel wall, spontaneous hyperdensity of the peribowel fat, and vascular dilatations are used to establish the bleeding site with helical CT. The presence of diverticula alone was not enough to define the bleeding site. Three-phase helical CT should be performed using intravenous contrast. Water can be used as an oral contrast in the workup of patients who are actively bleeding. Therefore, helical CT could be a good diagnostic tool in acute lower gastrointestinal bleeding to help the physician identify the bleeding site.
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| krsna
Forum Senior
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why not d ????
younger pts shud be evaluated for upper gi bleeding first
older pts for lower gi bleeding
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| webjeee
Forum Guru
Topics: 99
Posts: 349
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rectal exam, angiography, sigmoidoscopy
old, bright blood in stool, lower GI
the most common causes are hemorrhoids and diverticulosis, also cancer in the older.
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| ManuNastai
Transilvanian..
Topics: 55
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webjeee wrote:
old, bright blood in stool, lower GI
hematochezia means blood mixed with the stool. it most often ends up there from a colon bleeding, but can end up as nondigested blood mixted with stool from the upper part of the GI tract if there is a increased peristaltism of the intestine..
so.. B
Edited by ManuNastai on 01/08/07 - 09:09 AM
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