03-02-2016, 08:09 PM
D?
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sugesstion needed - dr_usmle2012
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03-07-2016, 11:24 AM
A 78-year-old woman comes to the geriatric clinic for a follow-up appointment. She was seen 3 weeks ago in the clinic for a routine appointment and was found to have a hematocrit of 28%. A rectal examination was positive for heme in the stool. Her only complaint is a long history of constipation. She has multiple medical problems including diabetes, hypertension, osteoarthritis, and a history of a myocardial infarction many years ago. To further evaluate her anemia, additional laboratory testing was initiated at that time. Since her last appointment, she had an outpatient barium enema and is now returning for the results of all her tests. An x-ray of the recto-sigmoid colon from the barium enema examination is shown. Serum laboratory tests are as follows: SQ785
Hg 9.8 g/dl Ferritin 10 ng/ml MCV 78 um3 At this time, the most appropriate next step is to A. admit the patient to the hospital for further evaluation B. do a colonoscopy C. encourage the patient to eat a high fiber diet D. order serum carcinoembryonic antigen (CEA-125) E. prescribe iron supplements
03-07-2016, 12:53 PM
need a female study partner, for CCS cases, exam in 1month.
03-16-2016, 10:28 PM
A 52-year-old man, who recently transferred to the city, comes to the office for a first visit complaining of weight loss and frequent malodorous stools. He admits to abusing alcohol and reports that he has developed chronic pancreatitis from his alcoholism. For the past year, he has given up alcohol completely and has transferred his job to your city. He reports that he has lost 20 pounds over the past 3 months. In addition, he reports frequent, greasy, malodorous stools. He denies any recent alcohol consumption and any abdominal pain. Laboratory studies and a CT scan of the abdomen confirm the diagnosis of chronic pancreatitis. A 72-hour fecal fat collection confirms steatorrhea. The most appropriate treatment for this patient is
A. endoscopic placement of pancreatic duct stent B. an enteric-coated pancreatic enzyme replacement tablet with meals and calcium-containing antacids C. a low-fat diet D. a non-enteric coated pancreatic enzyme replacement with H2 blockers E. octreotide |
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