PR bleeding - osce tutoring Flashcards
1
Q
How do you classify PR bleeding?
A
Anorectal
Colonic
2
Q
Hx
A
What is your normal bowel habit? Duration Frequency Amount Hypovolemic symptoms Characterise
3
Q
What would you ask about to clarify hypovolemic symptoms?
A
lightheadedness
collapse
chest pain
4
Q
Associated symptoms
A
Pain on defecation Abdo pain Any prolapse? Tenesmus - rectal cancer FLAWS Anaemia symptoms Change in bowel habit Mucus in stool
5
Q
Tenesmus
A
Rectal cancer
6
Q
Fever + PR bleeding
A
Diverticulitis
7
Q
Anaemia symptoms can be caused by
A
Coeliac disease
8
Q
Mucus in stool
A
Infective colitis
Rectal cancer
9
Q
PMHx
A
Rectal bleeding Chronic liver disease Surgical hx Trauma Bowel cancer Peptic ulcer diseaes IBD AF Bleeding tendencies
10
Q
FHx
A
Bowel cancer
IBD
Liver disease from haemochromatosis
11
Q
DHx
A
Iron tablets NSAIDs/steroids Beta blockers - hypovolemia Anticoag/platelets ABx -> c.difficile -> infectious colitis PPI
12
Q
Why ask about iron tablets?
A
Digestion of iron tablets can lead to dark stool which might mimic malena
13
Q
Colicky LLQ pain Fever Tiredness PR bleed
A
Diverticulitis
