Flag question A 52-year-old woman was noted on yearly examination to have a microcytic anemia. She has a long history of constipation and describes occasional hemorrhoidal bleeding, but otherwise denies any melena. She has no prior surgical history. Her only medical problem is an elevated cholestero! level that is controlled by diet. Her pulse is 92 BPM, blood pressure is 140/78 mm Hg, respiration rate is 14/min, and temperature is 98.7°F. Upon physical examination, no cervical or supraclavicular adenopathy is present and her head, eyes, ears, neck, and throat are normal. Her lungs are clear with equal breath sounds. Her heart has a regular pulse rate and rhythm, no murmurs, rubs or gallops. Abdominal exam reveals no organomegaly or masses. Rectal exam is notable for guaiac positive stool without any masses. Neurological examination is normal.