1. Explain the significance of the following in the protocol that my have a bearing to this patient's chief complaint.

 

 

 

 

 

 

 

2. What is/are the major clinical problem/s (not the diagnosis)?

 

 

 

 

 

 

 

3. What type of anemia does this patient have?  

 

 

 

 

 

 

 

4. What are the most common causes for this type of anemia. What is the most likely etiology in this patient and why?

 

 

 

 

 

 

 

5. Is this the result of acute bleeding or chronic bleeding?

 

 

 

 

 

 

 

6. What are the type of lesions that can cause chronic bleeding in GI tract?

 

 

 

 

 

 

 7. Let us next address the next major problem. Develop a differential diagnosis for constipation. 

The differential can be wide.

 

 

 

 

 

 

8. What is the most likely reason in this patient and why? Cite data from protocol to support your diagnosis.

Adenocarcinoma of the colon with mets to liver. 

Patient presents with a 

 

 

 

 

 

 

 

9. What is the significance of the laboratory in this case? How would you proceed to investigate the significance for elevated alkaline phosphatase?  

 

 

 

 

 

10. How would you confirm your clinical suspicion? What procedures will you request?

 

 

 

 

 

 

 

 

11. What do you think the liver CT will show?

 

 

 

 

 

 

12. What would you have done 6 months ago when the anemia was first discovered? Was there a malpractice?

 

 

 

 

 

 

 

13. How would you treat this patient?