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USMLE CS Cases: Colon Cancer

Discussion in 'USMLE' started by Egyptian Doctor, Jun 11, 2019.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Practicing medicine in:
    Egypt

    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
     

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