22 C/D Flashcards
67yo M presents with alternating diarrhea and constipation, decreased stool caliber, and blood in the stool for the past 8 months. He also reports unintentional weight loss. He is on a low-fiber diet and has a family history of colon cancer. His last colonoscopy was 12 years ago.
COLORECTAL CANCER irritable bowel syndrome diverticulosis GI parasitic infection (ascariasis, giardiasis) inflammatory bowel disease
rectal exam, stool for occult blood cbc electrolytes ast/alt/bili/alkphos colonoscopy barium enema ct abd/pelvis
28yo M presents with constipation (hard stool) for the past 3 weeks. Since her mother died 2 months ago, he and his father have eaten only junk food.
LOW-FIBER DIET depression substance abuse (e.g. heroin) irritable bowel syndrome hypothyroidism
rectal exam
TSH
electrolytes
urine toxicology
30yo F presents with alternating constipation and diarrhea by abdominal pain that is relieved by defecation. She has no nausea, vomiting, weight loss, or blood in her stool.
IRRITABLE BOWEL SYNDROME inflammatory bowel disease celiac disease chronic pancreatitis GI parasitic infection (ascariasis, giardiasis) lactose intolerance
rectal exam, stool for occult blood cbc electrolytes colonoscopy stool for ova and parasitology ct abd/pelvis
33yo M presents with watery diarrhea, vomiting, and diffuse abdominal pain that began yesterday. he also reports feeling hot. Several of his coworkers are also ill.
INFECTIOUS DIARRHEA (gastroenteritis) food poisoning
rectal exam, stool for occult blood stool leukocytes and culture cbc electrolytes ct abd/pelvis
40yo F presents with watery diarrhea and abdominal cramps. Last week she was on antibiotics for a UTI.
PSEUDOMEMBRANOUS COLITIS (C.diff colitis) Gastroenteritis Cryptosporidiosis Food poisoning inflammatory bowel disease
stool for C.diff toxin rectal exam, stool for occult blood stool leukocytes and culture cbc electrolytes
25yo M presents with water diarrhea and abdominal cramps. He was recently in Mexico.
TRAVELER'S DIARRHEA giardiasis amebiasis food poisoning hepatitis A
rectal exam stool leukocytes, culture, giardia antigen, entamboeba histolytica antigen cbc electrolytes ast/alt/bili/alkphos viral hepatitis serologies
30yo F presents with watery diarrhea, abdominal cramping and bloating. Her symptoms are aggravated by milk ingestion and relieved by fasting.
LACTOSE INTOLERANCE gastroenteritis inflammatory bowel disease irritable bowel disease hyperthyroidism
rectal exam
stool leukocytes and culture
hydrogen breath test
TSH
33yo M presents with watery diarrhea, diffuse abdominal pain, and weight loss within the past 3 weeks. He has a history of aphthous ulcers. He has not responded to antibiotics.
CROHN'S DISEASE Gastroenteritis UC celiac disease pseudomembranous colitis hyperthyroidism small bowel lymphoma carcinoid syndrome
rectal exam, stool for occult blood stool leukocytes and culture cbc electrolytes colonoscopy ct abdomen tsh small bowel series 5-HIAA
