Here is a nice, simple quiz on constipation. There will be a second part on diarrhoea appearing later. So for now, get your gloves on, grab yourself a Bristol Stool Chart and lets head to the murky world of altered bowel habits …
Reviewed by: awaiting review
Stem 1 of 4
A patient comes to his GP with constipation and pain in the LLQ for 3 months. He feels “a little thin” and exhausted. His ICE includes a fear his father started seeing blood in his faeces before dying of rectal cancer.
Given the presentation above, which is the least specific finding that would correlate to the best-matched differential?
Age of the patient
Palpable rectal mass
Reduced frequency of open bowels
Stem 2 of 4Which of the following is not a first line investigation to order in this patient?
Carcinoembryonic antigen (CEA)
Contrast barium enema
Stem 3 of 4A colonoscopy is performed and a sigmoidal mass is located. What is the root value most associated with the referred pain of this patient?
Stem 4 of 4Staging of the tumour reports: T3N0M0. What is the first line management?
Stem 1 of 2
A patient is recovering after an emergent exploratory laparotomy. Surgical examination was normal and the procedure had no complications. He is constipated and on the highest titre of morphine possible.
The patient is co-prescribed medications to limit side effects. Which of the following options would you consider least appropriate?
Stem 2 of 2Which physiological receptors contribute to opiate-induced constipation?
a single mass that is about 4cm wide and causes significant straining with some anal canal laceration. The patient states they have had more flatus recently.
Calculate the patient Bristol Stool score
Stem 1 of 3
Post-operatively, a patient is constipated and bloated. On auscultation, no bowel sounds are present.
Which electrolyte disturbance below are you particularly concerned about?
Serum calcium 2.3mmol/L
Serum chloride 100mmol/L
Serum magnesium 0.8mmol/L
Serum potassium 6.0mmol/L
Serum sodium 140.0mmol/L
Stem 2 of 3The myenteric plexus is located in which plane of the gut wall?
Within the adventitia
Within the mucosa
Within the muscularis propria
Within the serosa
Within the submucosa
Stem 3 of 336hr after the procedure, the patient has a high fever and rigors. He has bibasal rales on auscultation and is coughing green sputum. Given the likely cause of the postoperative pyrexia, what is the most appropriate empirical therapy to commence?