Chapter 6 ■ PRACTICAL APPLICATIONS 115
Chapter Six
PRACTICAL APPLICATIONS
Name: ______________________________
History and Plan cc: Leonard Smith, M.D.
Identifying Data:
This 72-year-old female presents with a biopsy proven adenocarcinoma of the sigmoid colon at
20 cm.
History of Present Illness:
The patient has been noted to have some bright red bleeding intermittently for approximately
8 months, initially presumable of a hemorrhoidal basis. She recently has had intensification of
the rectal bleeding but no weight loss, anorexia, or obstructive pain. No significant diarrhea or
constipation. Some low back pain, probably unrelated. Recent colonoscopy by Dr. Scoma revealed
a large sessile (attached by a broad base) polyp, which was partially excised at the 20-cm level,
showing infiltrating adenocarcinoma at the base. The patient is to enter the hospital at this time,
after home antibiotic and mechanical bowel prep, to undergo sigmoid colectomy and possible
further resection.
Questions
1. The patient has had which of the
following chronic symptoms: …………..
A. Loss of appetite
B. Melena
C. Hematochezia
D. Loose stools
2. The cause of her chronic symptom
was: ……………………………………………
A. Glandular tumor of the stomach
B. Swollen rectal veins
C. Ulcerative colitis
D. Malignant tumor of the colon
3. What procedure did she have recently
that diagnosed her condition? ………….
A. Visual examination of her large intestine
B. Removal of her sigmoid colon
C. Low anterior resection of the large intestine
D. Hemorrhoidectomy
4. The patient is scheduled for which
of the following procedures? ……………
A. Biopsy of the sigmoid colon
B. Excision of polyp in her colon
C. Removal of the sigmoid colon and possible
excision of additional colon tissue
D. Removal of 20 cm of colon, including the
sigmoid colon