PAEA Surgery End Of Rotation (EOR) Practice Exam

What are the common differential diagnoses for melena and hematochezia?

1. Appendicitis, diverticulitis, colon cancer

2. Diverticulosis, diverticulitis, colon polyps

3. Cholecystitis, pancreatitis, gastritis

4. Gallstones, hepatitis, cirrhosis

The correct answer is: Diverticulosis, diverticulitis, colon polyps

The common differential diagnoses for melena (black, tarry stools indicating upper gastrointestinal bleeding) and hematochezia (bright red blood per rectum often indicating lower gastrointestinal bleeding) primarily include conditions affecting the colon or rectum. Diverticulosis is a common condition characterized by the formation of small pouches in the colon wall, which can lead to diverticulitis, an inflammation of those pouches. Both conditions can result in bleeding, especially if a diverticulum ruptures or becomes inflamed. Colon polyps can also contribute to hematochezia since they can bleed, either due to malignancy or other irritative processes. In contrast, the other options listed are less directly related to the specific presentation of melena and hematochezia. Appendicitis primarily presents with right lower quadrant pain and may lead to perforation, but it is not typically associated with melena or hematochezia. Cholecystitis and pancreatitis involve pain and gastrointestinal upset but do not primarily present with gastrointestinal bleeding. Similarly, gallstones, hepatitis, and cirrhosis involve liver-gallbladder interactions and systemic effects but are not common causes of either melena or hematochezia. Thus, option B is correct, as it encompasses conditions directly