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Professor: What’s the most likely 1_______ in this case?
Student: Most probably carcinoma of the bowel with 2_______ blood loss.
Professor: What’s against that as a diagnosis?
Student: Well, we hasn’t had any change in this bowel habit, or lost weight.
Professor: What else will you include in the differential diagnosis of severe anaemia in a man of this age?
Student: He might have leukaemia of some sort, or aplastic anaemia, but that’s rare – it would be very unusual. Another cause is iron deficiency, but he seems to have an adequate 3_______.
Professor: OK. There’s another cause of anaemia which I think is more likely.
Student: Chronic bleeding ulcer?
Professor: Yes, that’s right. But what about pernicious anaemia? Can you exclude that?
Student: Well, he’s got none of the typical neurological 4_______, like paraesthesiae.