Patient Details

Fredrick Cunningham

76

M

Perindopril 5mg PO mane

Atorvastatin 40mg nocte

Patient has had painless PR bleeding for 3 days prior to seeing the GP and has been noticing tenesmus over the last few months.

Symptoms started roughly 3 months ago when the patient noticed his stool was red in colour and it did not change in consistency. He did not have diarrhoea nor feeling of lump when passing stools. He had the feeling of not completely evacuating -his bowels after going to the toilet. This patient has unintentionally lost some weight over the last 6 months but could not quantify the amount. He has had a reduction of exercise capacity but has not had any cardiac symptom.

On examination with the GP, he noticed a palpable rough mass on digital rectal examination and made an urgent referral to the local surgeon for investigation with a colonoscopy.

Cholecystectomy – no post-op complications

Hypertension

Dyslipidaemia

Penicillin – reaction: swelling of lips, rash, no anaphylactoid reactions

Mother died from myocardial infarction 15 years ago. Father died 50 years ago from a farm accident with no relevant medical history. Patient believes his maternal grandfather had bowel cancer, as did a maternal aunty. The ages of their diagnoses is not clear.

Patient and his wife recently sold their farm and moved into town for retirement. They have the support of a local daughter and son-in-law.

Had a 25-pack-peryear smoking history but stopped 35 years ago. Has about 4-5 schooners of beer a week.