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A 63-Year-Old Man Comes to the Emergency Department Due to Easy

question 601

Multiple Choice

A 63-year-old man comes to the emergency department due to easy fatigability and mild abdominal discomfort over the past several days. He also has had intermittent episodes of black-colored stool but has had no chest pain, palpitations, or syncope. His medical history is significant for hypertension, hyperlipidemia, and osteoarthritis. The patient takes amlodipine, lisinopril, and simvastatin. He also takes over-the-counter ibuprofen for hip and back pain that has been "acting up" over the past few weeks. The patient does not use tobacco or illicit drugs and drinks alcohol occasionally. Temperature is 37 C (98.6 F) , blood pressure is 106/64 mm Hg supine and 100/72 mm Hg after 3 minutes of standing, and pulse is 98/min. The patient appears pale but is otherwise in no distress. Lung auscultation is normal. Cardiac examination is unremarkable. The abdomen is soft and nondistended with mild epigastric tenderness and hyperactive bowel sounds. Rectal examination shows occult blood-positive melenic stool. Laboratory results are as follows: Adequate venous access is established, and intravenous crystalloids and pantoprazole are started. Preparation for upper gastrointestinal endoscopy is made. Which of the following is the most appropriate next step in management of this patient?

Definitions:

Perceptual Equivalence

The phenomenon where different stimuli are perceived as identical due to the perceptual system's interpretation, leading to a consistent perception of an object regardless of changes.

Spatial Equivalence

The concept that two or more entities occupy the same area or space in relation to each other.

Propositional Representation

The theory that all knowledge can be expressed in semantic-based propositions or statements, depicting relationships between concepts.

Verbal

Pertaining to words and language, especially the use and understanding of words in communication and reasoning.