TY  - CHAP
M1  - Book, Section
TI  - Patient with Bleeding Disorder - Case 3
A1  - Hoffman, Philip
A2  - Stern, Scott D.C.
A2  - Cifu, Adam S.
A2  - Altkorn, Diane
Y1  - 2020
N1  - 
T2  - Symptom to Diagnosis: An Evidence-Based Guide, 4e
AB  - PATIENT  Ms.  W  is  a  56-year-old  woman  who  comes  to  the  office  complaining  of  poor  appetite  for  several  weeks  and  black,  tarry  stools  with  generalized  weakness  for  1  day.She  has  no  prior  history  of  bleeding,  and  her  3  prior  obstetric  deliveries  were  uncomplicated.  Her  past  history  is  notable  for  cirrhosis  due  to  chronic  hepatitis  C.  Her  medications  include  spironolactone  and  metoprolol;  additionally,  she  has  been  taking  ibuprofen  for  back  pain.On  examination,  she  is  pale.  Her  blood  pressure  is  110/80  mm  Hg,  pulse  is  112  bpm,  RR  is  16  breaths  per  minute,  temperature  is  37.1°C.  Her  conjunctivae  are  pale,  mucous  membranes  moist,  lungs  clear,  heart  regular  rhythm  with  a  systolic  flow  murmur  at  the  left  sternal  border,  liver  minimally  enlarged  with  a  nodular  edge,  spleen  palpable  3  cm  below  the  left  costal  margin  in  the  anterior  axillary  line,  and  she  has  no  edema.  Digital  rectal  examination  discloses  black  stool  that  is  Hemoccult-positive.At  this  point,  what  is  the  leading  hypothesis,  what  are  the  active  alternatives,  and  is  there  a  must  not  miss  diagnosis?  Given  this  differential  diagnosis,  what  tests  should  be  ordered?  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/09/11
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1185662795
ER  -