A 52 year-old Netive Armarican women with obsesty and hypothyrold lem presente to an…

A 52 year-old Netive Armarican women with obsesty and hypothyrold lem presente to an urgent cere citic affillated with her PCP-a prectice for rectal bleeding for the peat 3 months, Initiaty, it heppened about ance a weak during a bowel movement but wee currenty occuring deliy with all bowel movements. She describes the blood as approafrnately 1 teaspoon, dark red, and mined in the atool, She denies any associated rectal or abdominel peln, and her bowel movememts are regular mery dey without change, although they do seem thinner, which she ettr butes to stearting a low-carbohydreme diet 4 months aga. She releye a history of Internal hernorinoide after the birth of her deughter 20 yeare ago, with reare bleading throughourt the years that atwere impreves within a dey of spping over-the-counter hemorriold creem, Despite using thle cream delly now, there hes been no Improvement in current symptime. Though she wee referred for coloroecopy screening et ege 60, she never scheduled it because sha wes “efreld of the prep” end did not want to mles a whole dev o work, She rate she called her reguler PCP 3 momth ego about her b eding. “He se there end get a coloncecopy done.” The procedure to schedund in 3 weaks, the aarllest evelteble for the “touthes screening” referrel bert, The patient se ked whether “the telce-home test” or ” dirtuel coloncecopy” cound be ordered todey for quicker resume.