A 42-year-old man comes to the office with rectal bleeding. He used to have occasional streaks of blood on the tissue after wiping, but for the past several days e has seen blood dripping into the toilet bowl at the end of defecation. The patient eports chronic constipation and has to strain during defecation but has no rectal or abdominal pain. He works as a truck driver, and his diet consists mainly of amburgers and French fries. Abdominal examination is unremarkable. There is no nass or tenderness on digital rectal examination, but anoscopy shows bulging uEnlich blue al locie ahoue the ntete line Rubber bend igati
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- The surgical removal of all or part of the sigmoid colon is a/an ___________________.Ken is a 42-year-old male who presented to the ER complaining of severe flank pain on and offfor the past six hours. He is complaining of fever and chills along with nausea, but has notvomited as yet. He also reports difficulty with voiding, stating that “It feels like I have tourinate, but when I try, I only pass a small amount of urine and there is some blood in it.” Hedescribes the pain as a sharp, stabbing type of pain that started in his lower back on the leftside and then traveled around to the front and down into his groin area. He has taken twodoses of ibuprofen 400 mg with minimal relief.1. Based on Ken’s symptoms described above, what diagnosis is most likely in this case?2. Based on Ken’s symptoms, explain what most substantiates the diagnosis?3. What other relevant information might there be in Ken’s past history, social history, andfamily history that could assist the ER physician in supporting the diagnosis?(Must answer with 6 possible outcomes)4. What diagnostic tests…Male, 50 years old, was admitted to the emergency department with abdominal pain for 7 hours The patient overate 8 hours before and felt discomfort in the upper abdomen after drinking alcohol. 7 hours ago, there was sudden severe pain under the xiphoid process, accompanied by nausea and vomiting of stomach contents several times. 5 hours ago, abdominal pain spread to the right lower abdomen with onset of fever. The patient refused to press the abdomen due to pain, irritable, and had cold sweats. Physical examination: T38.6 °C, P104 /min, R24 /min, BP100/60mmHg. Acute painful appearance, irritability, no obvious lesions in cardiopulmonary examination, flat abdomen, no gastrointestinal and peristaltic waves, extensive abdominal muscle tension, tenderness in the subxiphoid area and right middle and lower abdomen, obvious rebound pain. The most prominent undershoot, liver and spleen are not reached, Murphy sign (-), shifting dullness (-). dullness (-). Bowel sounds are heard occasionally,…
- A man is experiencing cough issues after days of masturbation or sexual intercourse. What doctor he should visit to get a medical attention?A 25 year old, previous)y healthy woman came to the emergency room for the evaluation of bloody diarrhea and diffuse abdominal pain of 24 hours' duration. She complained of nausea and had vomited twice. S reported no history of infammatory bowel disease, previous diarrhea, or contact with people with diarrhea. The symptoms began 24 hours after she had eaten an undercooked hamburger at a local fast food restaurant Rectal examination revealed watery stool with gross blood. Endoscopy tests showed diffuse mucosal erythema and petechia with a modest exudation but no ulceration or pseudomembranes. 1. Name the four genera of Enterobacteriaceae that can cause gastrointestinal disease. Which two can cause hemorrhagic colitis? 2. What virulenca factor causes the symptoms described in this clinical case? Describe the toxin mechanism of action. 3. Name the five groups of E coli that can cause gastroenteritis. What is the characteristic of each group? 4. What are the forms of Salmonella infection?…Jeanette is a 46-year-old woman who has visited her general practitioner (GP) today, brought in by her husband, Steve, with a 5-day history of nausea, mild abdominal pain and constipation. She decided to see the doctor today, as the pain and nausea were much worse when she woke up this morning and she has vomited twice in the past 3 hours. She also reports her abdomen feels distended and bloated. Jeanette says she had tried to drink more water and eat more fruit and was having bran for breakfast for the past 3 days, as she initially thought she was simply constipated. With the increased generalized abdominal pain and vomiting this morning, she thought she should get a medical opinion. Jeanette has a past medical history of hypercholesterolemia, hypertension, atrial fibrillation and type 2 diabetes mellitus (T2DM) and her BMI is 32 kg/m2. She experienced appendicitis 6 months ago,for which she had an appendectomy. Her current medications are simvastatin, warfarin, and metformin. The GP…
- lunch meal that you can recommend to patient has ulcerative colitis with drinksA 22 year old black woman present with complaints of burning and frequency of urination for the past 2 to 3 days. It is getting worse. She feels she has to void, rushes to the bathroom and then is only able to void a small amount. it is painful. There is no sign of blood in the urine. She denies fever, chills, diarrhea, nausea, vomiting or vaginal discharge. " I have to rush to the bathroom, and it hurts when I urinate". Physical Ex: Essentially unremarkable. Negative suprapubic tenderness: negative costovertebral angle tenderness. Negative abdominal pain and benign abdominal exam. Negative back pain. Afebrile. Vital signs normal. No complaints of vaginal discharge. Uranalysis shows+ WBCs, trace RBCs. What additional data are important to factor into this picture? Do you do vaginal ex and why? Should you do urine culture and sensitivity? What are things in the medical history that may provide clues to the possible cause of dysuria? What are the possible differential diagnoses for…Male, 30 years old, who was admitted to the emergency room with abdominal pain for 4 hours The patient felt upper abdominal discomfort after drinking and overeating 5 hours ago, and felt sudden acute pain under xiphoid process 4 hours ago, accompanied by nausea and vomiting of stomach contents for several times, abdominal pain spread to the right middle and lower abdomen 3 hours ago. The patient refused to press the abdomen because of pain, fidgeting, cold sweat. PE: flat abdomen, extensive muscle tension, obvious tenderness under xiphoid process, right middle and lower abdomen, most prominent under xiphoid process, bowel sounds occasionally heard. For further diagnosis and treatment, she was admitted to the emergency department. Intermittent epigastric pain for 8 years, apparent hunger, without systematic diagnosis and treatment. PE: T37.6℃, P104 times/min, R24 times/min, BP90/60mmhg. Acute painful appearance, irritability, no obvious changes in cardiopulmonary examination, flat…
- A 24 year old female was admitted to the hospital complaining of severe abdominal pain with bloody diarrhea 20 times per day for the past 2 days. What could be the diagnosis? mWhich of the following is correct withregard to obtaining a rectal temperature? Because of its invasive nature andrisk for injury to rectal mucosa, it isnot recommended as the site offirst choice Rectal temperature readings areappropriate in all clients if anaccurate temperature is needed An oral thermometer may be usedto obtain a rectal temperature ifnecessary A rectal temperature reflectssurface temperatureMale, 29 year old, old, admitted to emergency department due with abdominal pain for 2 days. The patient had a sudden attack of total abdominal pain 2 days ago, especially in the right lower abdomen. It was paroxysmal colic, accompanied by intestinal ringing, and he vomited many times. The vomit turned from a green color to a fecal odor. In the past two days, he did not eat or drink with no flatus and defecation, and had little urine and no fever. He had an appendectomy three years ago. Physical examination: acute appearance, clear mind, BP 100/60mmHg, P 132/min, t 37.5 °C, no yellow dye, dry skin, poor elasticity. The heart and lungs are normal. The abdomen is distended, no intestinal type is found, the whole abdomen is soft by palpation, there is extensive slight tenderness, no rebound pain, no mass is touched, the liver and spleen are not enlarged, the bowel sounds are high. was was Auxiliary examination: HB 160g/L, WBC 10.6 × 10%L, negative urine routine test. X-ray showed multiple…