History : HPI: 66 yo M c/o blood in the stool. -1 month ago red mix with stool, persistent,no weakness, no changes in appetite, lost 10 lb last 6 months ago. Hx of constipation 2 bowels a week. -diarrhea 2 days ago, took amoxicillin a month ago for URI. -No mucous, urgency, or tenesmus with dedication -No travel, SOB, chest palpitation. ROS: negative except as per HPI PMH: Hemorroids ressected 3 X; Allergies: NKDA; meds: None currently used to use laxatives FH: father had colon cancer died at 55; SH: accountant, no smoking no drinking, sexually active with his wife Physical Examination : NAD VS: WNL Heart: Normal S1S2 no murmurs, rubs or gallop Lung: Norma breath sound bilaterally Abdomen: soft non distended, non tender to light or deep palpation, no rebound tenderness, no heaptospleenomegaly Diagnosis 1 : colon cancer Diagnosis 2 : Hammoroids History Findings Physical Exam Findings 1) blood on there stool 1) pale conjunctivita 2) weight loss unintentional 3) age > 50, father dies of colon cancer at 55 4) polyp on last colonoscopy 10 years ago History Findings Physical Exam Findings 1) Hx of hemorrhoids 2) bright red blood with stool Diagnosis 3 : Pseudomembrane colitis Diagnostic Study/Studies - Labs 1) rectal exam with fecal occult blood analysis 2) CBC 3) colonoscopy 4) fecal leukocyte History Findings Physical Exam Findings 1) diarrhea 2) use of amoxicillin 1 month prior
