Bright Red Blood
The patient is a 36 year old male who came to the hospital because of an episode of hematemesis. The patient stated that for the past few days he had had anorexia and epigastric pain, which was worse if he tried to eat. An NG tube was placed and drained a small amount of bright red blood, as well as some coffee-ground material. Hemoccult test showed dark, tarry stool and positive for occult blood.
1. Where do you suspect the patient is bleeding from?
2. What are some of the possible conditions that could be causing the bleeding?
3. What tests would you order to make a more specific diagnosis?
Patient Three
The patient is a 21 year old male who presented with a history of sudden onset of abdominal pain, first generalized, and then localizing to the RLQ. The pain was accompanied with anorexia and nausea. It has become increasingly more severe over the past 3 hours so that the patient now cannot walk. He had one episode of vomiting, and has a low-grade fever of 100. On examination the patient was in acute distress due to pain. Palpation of the abdomen showed generalized tenderness with marked pain in the RLQ and rebound pain. STAT CBC showed leukocytosis of 21,000. Abdominal ultrasound was ordered.
1. What do the results of the CBC tell you about this patient’s condition?
2. What structures are located in the Right Lower Quadrant?
3. What do you suspect is wrong with this patient?
4. If your suspicion is correct, what will be the
1. Where do you suspect the patient is bleeding from?
2. What are some of the possible conditions that could be causing the bleeding?
3. What tests would you order to make a more specific diagnosis?
Patient Three
The patient is a 21 year old male who presented with a history of sudden onset of abdominal pain, first generalized, and then localizing to the RLQ. The pain was accompanied with anorexia and nausea. It has become increasingly more severe over the past 3 hours so that the patient now cannot walk. He had one episode of vomiting, and has a low-grade fever of 100. On examination the patient was in acute distress due to pain. Palpation of the abdomen showed generalized tenderness with marked pain in the RLQ and rebound pain. STAT CBC showed leukocytosis of 21,000. Abdominal ultrasound was ordered.
1. What do the results of the CBC tell you about this patient’s condition?
2. What structures are located in the Right Lower Quadrant?
3. What do you suspect is wrong with this patient?
4. If your suspicion is correct, what will be the