4.4 of 7 Ratings
A 24-year-old woman presents with 3 days of diarrhea. She was recently on vacation in Peru and admits that on her last day of the trip she enjoyed a dinner of the local food and drink. Upon return to the United States the next day, she developed abdominal cramps and watery diarrhea, occurring about 3-5 times per day. She has not noticed any blood or mucous in her stool. Vital signs are stable. On physical examination, she is well appearing in no acute distress. Which of the following is commonly associated with the likely underlying illness?
Unwashed fruits and vegetables
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A 30-year-old male presents to the emergency department with a complaint of abdominal pain. The patient states he was at a barbecue around noon. Lunch was arranged as a buffet without refrigeration. Within 2 to 3 hours, he had abdominal pain associated with multiple episodes of vomiting, retching, and watery diarrhea. On exam, vital signs are T 99.1, HR 103, BP 110/55, RR 14. Abdominal exam is significant for pain to deep palpation without any rebounding or guarding. There is no blood on fecal occult testing (FOBT). What is the most likely cause of this patient's presentation?
A 30-year-old man presents to the emergency department with diarrhea. He states he has had profuse, watery diarrhea for the past 24 hours. He notes that eating and drinking make him defecate so he has refrained from eating. He is otherwise healthy and takes no medications. His temperature is 97.7°F (36.5°C), blood pressure is 84/64 mmHg, pulse is 130/min, respirations are 17/min, and oxygen saturation is 99% on room air. Physical exam reveals dry mucous membranes with an otherwise benign exam. The patient is given 1L of normal saline and drinks 1L of oral fluids. His blood pressure is subsequently 120/70 mmHg and pulse 95/min. Which of the following is the most appropriate next step in management?
Rest and oral rehydration
Stool ova and parasite study
A 44-year-old man presents to the emergency department acutely confused. The patient’s wife states she found him lethargic at home. He has been sick the past week with diarrhea and has been staying home from work. He is otherwise healthy and does not take any medications. His temperature is 97.5°F (36.4°C), blood pressure is 62/32 mmHg, pulse is 185/min, respirations are 25/min, and oxygen saturation is 98% on room air. The patient has profuse, bloody diarrhea while in the emergency department. The patient is given 3L of ringer lactate and subsequently appears less confused, with a blood pressure of 100/70 mmHg. He is able to drink oral fluids and protect his airway. An ECG is performed as seen in Figure A. He continues to have diarrhea while in the emergency department. Which of the following is contraindicated in the management of this patient?