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  #1  
Old 12-08-2011
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Question Management of diarrhea..WTF!

A 22-year-old man presents to the emergency department with a 24-hour history of 8 to 10 episodes of liquid stools without blood. There is associated diffuse abdominal cramping pain relieved by each bowel movement. The patient denies tenesmus. There is no similar problem in the past, and no one else in the family has this problem. The patient also denies recent travel.
His pulse rate is 94/min, and blood pressure is 148/96 mm Hg. There is no orthostatic hypotension, and his temperature is 37 C (98.6 F). His abdomen is soft and nontender. What is the best initial approach to this patient?
(A) Admit for observation
(B) Stool for cultures, ova, and parasites, and complete bloodcount chemistry
(C) Empiric antibiotic therapy with trimethoprim/sulfamethoxazole or ciprofloxacin
(D) Reassurance and oral fluids
(E) Flexible sigmoidoscopy with mucosal biopsies
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Old 12-08-2011
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diarrhea without vomiting => Reassurance and oral fluids
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Old 12-08-2011
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yup reassurance and oral fluids..
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Old 12-08-2011
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Agreed with others
(D) Reassurance and oral fluids
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Old 12-08-2011
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Still wondering why the wtf
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Old 12-08-2011
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Quote:
Originally Posted by bassatom View Post
Still wondering why the wtf
me too!
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Old 12-08-2011
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lol i guess he is wondering about why he has no hypotension and actually he is a little bit hypertensive for his age.. But it could be because of stress hormones i guess
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Old 12-08-2011
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(D) Reassurance and oral fluids
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Old 12-08-2011
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Quote:
Originally Posted by sam88 View Post
lol i guess he is wondering about why he has no hypotension and actually he is a little bit hypertensive for his age.. But it could be because of stress hormones i guess
Either the question is ill-formed or patient may have preexisting condition like pheochromocytoma. Still answer remains same Ressurance and fluid intake.
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Old 12-08-2011
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Quote:
Originally Posted by bassatom View Post
Still wondering why the wtf
answer is fluid and reassurance.



may i know why not stool for culture, ova and cysts? in order to rule out diarrhea is not invasive...[ can give ciprofloxacin if it is invasive]
any idea?
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  #11  
Old 12-08-2011
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The etiology of the diarrhea is rarely required for mild and moderate diarrhea.
if the diarrhea didnt get better or become more severe or if there is accompanied abdominal pain, fever or blood then you would do a stool culture..etc after starting an intravenous fluids.
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