With Time

Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This elderly man has presented following the passage of blood per-rectum. His only known comorbidity is asymptomatic moderate aortic stenosis. He was stable on admission and did not develop re-bleeding afterward. Investigations show a picture suggestive of iron-deficiency anemia.\n \nThe above combination of findings is suggestive of a colonic source of bleeding; the presence of iron deficiency anemia is particularly ominous, indicating that subclinical bleeding may have been going on for some time now. A colorectal malignancy is a serious consideration here.\n \nColonoscopy is an essential next step. This however, reveals angiodysplasia of the right colon. Note that angiodysplasia are a complication of aging, and are not uncommon in the elderl"}]}

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