Gastroenterology Quiz #21: Gastrointestinal Bleeding

1. A 67-year-old man with a history of chronic alcohol use presents to the emergency department with hematemesis. He has a history of peptic ulcer disease but has not been compliant with medications. Physical examination reveals mild jaundice and spider angiomas. Laboratory tests show an elevated INR. Which of the following is the most likely source of his gastrointestinal bleeding? 

Question 1 of 5

2. A 72-year-old woman presents with melena that has persisted for two days. She has a history of rheumatoid arthritis for which she takes ibuprofen regularly. She denies vomiting or significant abdominal pain. On physical examination, she is hemodynamically stable, and her abdominal examination is unremarkable. Which of the following is the most likely cause of her gastrointestinal bleeding?

Question 2 of 5

3. A 55-year-old man with a history of hypertension and chronic kidney disease presents with bright red blood per rectum. He denies any abdominal pain, vomiting, or changes in bowel habits. His medications include aspirin and lisinopril. On physical examination, his blood pressure is 145/90 mmHg, and rectal examination reveals bright red blood without any anal fissures or hemorrhoids. Which of the following is the most likely diagnosis? 

Question 3 of 5

4. A 30-year-old woman presents with a one-week history of black, tarry stools and lightheadedness on standing. She has a history of menorrhagia but denies any recent use of NSAIDs or alcohol. Laboratory tests reveal a low hemoglobin level and low serum ferritin. Which of the following is the most appropriate next step in management? 

Question 4 of 5

5. A 45-year-old man with a known history of Crohn's disease presents with a sudden onset of bright red blood per rectum. He denies any recent use of NSAIDs, alcohol, or a history of liver disease. On examination, he is tachycardic and his abdominal exam reveals tenderness in the right lower quadrant. Which of the following is the most likely source of his gastrointestinal bleeding?

Question 5 of 5


 

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