Instructions
You are a medical student on placement in the emergency department. Your next patient is Enzo Rossi, 54, presenting with dark vomit and black stools. His blood results are below.
Take a focused history
Examine the patient
Outline to the examiner:
- Your findings
- Your interpretation of the results
- Your most likely diagnosis and differentials
- Next steps in management, including relevant investigations
Blood tests
| Item | Value | Reference range |
|---|---|---|
| Haemoglobin | 82 | 130-180 g/L |
| Haematocrit | 0.25 | 0.40-0.54 |
| White cell count | 6.8 | 4.0-11.0 x 10^9/L |
| Platelets | 286 | 150-400 x 10^9/L |
| Urea | 15.2 | 2.5-8.0 mmol/L |
| Creatinine | 92 | 60-110 umol/L |
| Sodium | 138 | 135-145 mmol/L |
| Potassium | 4.4 | 3.5-5.0 mmol/L |
| INR | 1.1 | 0.9-1.2 |
| ALT | 24 | 5-40 U/L |
| ALP | 28 | 30-110 U/L |
| Bilirubin | 14 | 3-20 umol/L |
| CRP | 4 | <5 mg/L |