Sep 27, 2023, 14:12 by Sarah Moore

A 52-year-old white male presented to the emergency room (ER) with a chief complaint of “passing blood from my rectum.” The bleeding was acute in onset and began approximately 18 hours ago. He has had a total of four episodes of bright red blood per rectum. In the first two episodes, he passed a mixture of stool and blood; however, in the two most recent episodes, he passed only blood. He describes each episode as a “large amount of blood.” He has no other symptoms, including no abdominal pain. In the ER, his initial heart rate was 110, and his blood pressure was 98/64. He received one liter of normal saline with a decrease in his heart rate to the low 90s and improvement in his blood pressure to 110/70. Hemoglobin on presentation was 11.2. He had a normal complete blood count (CBC) and comprehensive metabolic panel (CMP) one year ago. The last colonoscopy was two years ago; it was negative for polyps and cancer. He was told he had “pockets” in his colon. He has well-controlled hypertension on lisinopril 20 mg po daily.

Sep 27, 2023, 14:12 by Sarah Moore

A 45-year-old Caucasian male presented to the ED with melena for 7 days. On further questioning, patient reported intermittent dyspepsia, nausea, early satiety and bloating for the prior 6 weeks. He had decreased his oral intake secondary to these symptoms and has had a 10-pound weight loss. He admits to dizziness. He denies fevers, chills, vomiting, hematemesis, jaundice.

Sep 27, 2023, 14:11 by Sarah Moore

A 45-year-old African American female presents to her gastroenterologist for an open access screening colonoscopy. Currently, she is asymptomatic. She has no known family history of colon cancer or colon polyps. This is her first colonoscopy. Past medical history includes hypertension, well-controlled on chlorthalidone. She exercises 4-5 times per week and adheres to a low-fat diet. She drinks 2-4 glasses of wine per week. She does not smoke or use recreational drugs.

Sep 27, 2023, 14:07 by Sarah Moore

The patient is a 34-year-old Caucasian female who presents with a chief complaint of “abnormal liver labs”. She states that over the last six months she has lacked energy and is easily fatigued. She’s an avid cyclist, however this has become more difficult due to fatigue. She has no other complaints. Due to the severity of fatigue and its impact on her regular activities, she went to her primary care physician. Her evaluation, including abdominal ultrasound, was negative except for a mild elevation of the AST and ALT at 72 U/L and ALT 90 U/L respectively. Her platelet count, albumin, bilirubin, and alkaline phosphatase are all normal.