Instructions
You are a medical student on placement in a regional emergency department. Your next patient is Giuseppe Rossi, 76, who has vomited fresh blood. 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 | 88 | 130-180 g/L |
| Haematocrit | 0.27 | 0.40-0.54 L/L |
| White cell count | 14.8 | 4.0-11.0 x 10^9/L |
| Platelets | 280 | 150-400 x 10^9/L |
| CRP | 86 | <5 mg/L |
| Urea | 12.4 | 3.0-8.0 mmol/L |
| Creatinine | 105 | 60-110 umol/L |
| Lactate | 1.8 | 0.5-2.2 mmol/L |
| INR | 1.1 | 0.8-1.2 |
| APTT | 29 | 25-35 seconds |
| Bilirubin | 14 | <20 umol/L |
| ALT | 22 | 5-40 U/L |
| ALP | 108 | 30-110 U/L |
| Albumin | 36 | 35-50 g/L |