exam 2 - diarrhea

Question 1

44 y/o male with no significant PMH, presents with NVD and blurred vision for 2 days. physical exam found ptosis of left eye. What is the provisional dx and probable source of contamination

Answer 1

provisional Dx: infectious diarrhea of clostridium botulinum etiology

Source: most likely source is home-canned or poorly canned food

Question 2

33 y/o female, with PMH of IBS, presents with explosive diarrhea and increased flatulence for 1 week. examination of stool found contents to appear greasy and have a foul-smelling odor. The patient states she went to the lake 2 weeks ago but nobody else is sick she went with. The patient states this is different from her IBS

Answer 2

provisional Dx: infectious diarrhea of Giardia etiology

Question 3

29 y/o male, with PMH of anxiety, presents with acute, abrupt onset of NVD for 3 day with associated sxs of weakness and loss of appetite. exam and BMP/chem were insignificant

Answer 3

provisional dx: gastroenteritis

Question 4

diagnostic test to see if a patient is abusing laxative

Answer 4

Sodium Hydroxide test: phenolphalein in laxative turns stool red with sodium hydroxide is introduced

Question 5

Most common ABx that cause diarrhea

Answer 5

Ampicillin, tretracycline, clindamycin, lincomycin, chlormphenicol

Question 6

77 y/o female, with recent hospital stay for cellulitis, presents with foul-smelling diarrhea for 3 days. physical exam reveals diffuse abdominal pain and vitals: 38.2, 110HR, 102/55BP, 24RR

Answer 6

provisional dx: severe colitis most likely with c-diff etiology (pseudomembranous enterocolitis….need more information. probably from clindamycin tx)

Question 7

33 y/o women, with no PMH, presents with recurrent diarrhea for last 4 months, labs show hypokalemia and patient is lassitude

Answer 7

provisional dx: diarrhea of laxative abuse etiology (psychogenic origin)

Question 8

marked weight loss associated with persistent diarrhea and frothy, foul-smelling stools that sometimes float

Answer 8

steatorrhea (pancreatic or small-bowel)

Question 9

Acute diarrhea and severe vomiting (out of proportion to the diarrhea) beginning 2-4 hours after consumption of potentially contaminated foods (milk products, meats, ect)

Answer 9

toxic staphylococcal gastroenteritis

Question 10

Copious bleeding or blood mixed with the stools

Answer 10

ulcerative colitis

Question 11

Frequent small stools or diarrhea with the passage of blood, mucus, and occasionally pus.
Often have rectal leakage, nocturnal diarrhea, urgency, early morning rushes

Answer 11

inflammatory bowel disease

Question 12

Chronic diarrhea that alternates with constipation and is frequent in young women with children

Answer 12

IBS

Question 13

recurrent diarrhea in which the patient has a sense of incomplete evacuation

Answer 13

IBS

Question 14

33 y/o female, with PMH of diarrhea, presents with recurrent diarrhea, abdominal distention, and mucous in toilet. exam found colon to be tender on palpation. patient states she has had an increase in stress lately

Answer 14

IBS

Question 15

Uncontrolled explosive postprandial diarrhea

Answer 15

diarrhea of diabetic etiology