Case 11 – History


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Case 11

Gastrointestinal bleeding and sudden death


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Brief History

The patient was an elderly Caucasian woman with recent bleeding per rectum, anemia and unspecified cardiac arrhythmia.

She was hospitalized for her bleeding and received transfusions.

An endoscopy did not find the source of the bleeding.

Mobility at home was limited and she was scheduled for outpatient physical therapy.

On descending the stairs at home going to her first physical therapy appointment, she became short of breath.

She arrived at physical therapy where she collapsed and died.

The history is obtained from the family.


Next: External exam

Discussion Questions

1. Summarize the history.

2. What is the differential diagnosis for bleeding per rectum?

3. In general, why might an endoscopy not find the source of bleeding?

4. What causes of death does the history suggest? Which is most likely?