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Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

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6 Posts

hero
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01/01/08 - 03:59 PM

An 80-year-old woman comes to the emergency department because of an acute episode of painless lower gastrointestinal bleeding. Physical examination discloses orthostatic hypotension. Anorectal examination is normal except for the presence of gross blood in the rectal vault. Nasogastric aspirate contains copious bile but no blood.
Which of the following is the most likely diagnosis?
A. Bleeding internal hemorrhoids
B. Diverticulosis
C. Vascular malformation
D. lschemic colitis
E. Colorectal adenoma or adenocarcinoma

Ivonne
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01/01/08 - 04:10 PM

C------->vascular malformation.

Common cause of painless colonic bleeding in the elderly

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hero
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01/01/08 - 04:13 PM

Ivonne wrote:
C------->vascular malformation.

Common cause of painless colonic bleeding in the elderly

But not as common as diverticulosis

hero
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01/01/08 - 04:14 PM

B is correct answer

In large clinical series, diverticular disease and, less commonly, vascular malformations and neoplasms were among the most common causes of acute lower gastrointestinal bleeding. Hemorrhoids and ischemic colitis rarely produce the massive bleeding that this patient is experiencing.

Ivonne
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01/01/08 - 04:17 PM

true but i dont know why i thought that diverticulitis instead of diverticulosis was the one that bleed... rolling eyes

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Ivonne
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01/01/08 - 04:18 PM

I wont forget now...

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