Gastroenterology
Case 9: An Orthopaedic Patient Who Has Passed a Melaena Stool
CASE
An 84‐year‐old man passes a large melaena stool. He is an in‐patient on an orthopaedic ward 4 days after repair of a fractured neck of femur. He has a past history of coronary bypass surgery. He normally takes aspirin, atenolol and simvastatin. He has no indigestion or abdominal pain although he has felt nauseated since his surgery. On examination he looks pale and is cool to the touch. His pulse is 110 beats/min and BP is measured at 105/75 mmHg lying and 86/50 mmHg sitting up.
Blood tests showed:
Hb 8.4 g/dL WCC 4.6 × 109/L Platelets 230 × 109/L Na 137 mmol/L K 6.0 mmol/L Urea 22.4 mmol/L Creatinine 130 µmol/L
QUESTION 1
Your score this session: 0 of 0
What is the significance of a postural blood pressure drop?