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Amy, a 50-year-old woman, reports a recent change in her bowel habits and rectal bleeding. She has no family history of rectal or colon problems. What is the most appropriate next step for her healthcare provider?

A.

Perform a rectal examination

B.

Refer her to a colonoscopy immediately

C.

Recommend increasing fiber in her diet

D.

Prescribe anti-hemorrhoidal medication

Answer and Explanation

The Correct Answer is B

A.    A rectal examination may not detect lesions higher up in the colon

B.    Rectal bleeding and change in bowel habits are red flags for colorectal cancer, especially in people over 50 years old. A colonoscopy is the gold standard for diagnosing colorectal cancer and other conditions affecting the colon and rectum.
C.    While increasing fiber may be beneficial for overall bowel health, it is not the immediate action to take when rectal bleeding and changes in bowel habits are reported.
D.    Prescribing medication without a proper evaluation could mask underlying issues and is not the appropriate initial step.
 


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Related Questions

Correct Answer is ["B","D","E"]

Explanation

A. Radical neck dissection is a surgical procedure that removes the lymph nodes and other structures in the neck, and it is usually reserved for advanced cases or when radiation therapy fails.
B. Radiation therapy is often the main treatment for laryngeal cancer, as it can preserve the voice of the patient and avoid surgery.
C. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause a dry cough as a side effect, but it does not need to be discontinued unless there is another indication.
D. A PET scan can help determine the extent of cancer spread and guide treatment planning.

E. Dietary counseling is important to prevent malnutrition and dehydration, as dysphagia can impair oral intake.

Correct Answer is ["B","C","D"]

Explanation

A. Albuterol is used for bronchodilation and is not indicated for Sandra's presentation.

B. She needs arterial blood gas analysis to monitor her acid-base status, as she has a low pH indicating acidosis.
C. Sandra is a patient who has signs and symptoms of peritonsillar abscess, a complication of recurrent tonsillitis. She needs urgent treatment to prevent airway obstruction and sepsis.
D. Given Sandra's history of tonsillitis and elevated WBC count, initiating antibiotics targeting streptococcal infection is crucial.
E. While a chest X-ray may be indicated for respiratory symptoms, it's not the most immediate action needed for Sandra's management.

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