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9085 Medicine

A 26 year old man complains of abdominal distension, swelling of the legs and easy fatigability. His blood pressure is 90/70 mm Hg and pulse becomes difficult to feel on inspiration. JVP is grossly elevated and rises further on deep inspiration. He has pedal edema, ascites and tender hepatomegaly. Precordium is quiter with loud and some what early apical third heart sound. The probable diagnosis is –

ACor Pulmonale
BTricuspid steno sis
CConstrictive pericarditis
DPulmonary stenosis
Medicine
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9088 Medicine

A 78-year-old man presents to the emergency department with acute onset of bright red blood per rectum. Symptoms started 2 hours earlier, and he has had three bowel movements since then with copious amounts of blood. He denies prior episodes of rectal bleeding. He notes dizziness with standing but denies abdominal pain. He has had no vomiting or nausea. A nasogastric lavage is performed and shows no coffee-ground material or blood. Lab evaluation reveals hemoglobin of 10.5 g/dL. What is the most likely source of the bleeding?

AInternal hemorrhoids
BDieulafoy lesion
CDiverticulosis
DMallory-Weiss tear
Medicine
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