4.8 of 10 Ratings
Please rate this review topic.
You have never rated this topic.
Thank you. You can rate this topic again in 12 months.
A 25-year-old woman presents to her primary care physician complaining of several months of diarrhea. She has also had crampy abdominal pain. She has tried modifying her diet without improvement. She has many watery, non-bloody bowel movements per day. She also reports feeling fatigued. The patient has not recently traveled outside of the country. She has lost 10 pounds since her visit last year, and her BMI is now 20. On exam, she has skin tags and an anal fissure. Which of the following would most likely be seen on endoscopy and biopsy?
Diffuse, non-focal ulcerations with granuloma
Diffuse, non-focal ulcerations without granuloma
Pseudopolyps and continuous mucosal involvement
Focal ulcerations with granuloma
Friable mucosa with pinpoint hemorrhages
Select Answer to see Preferred Response
A 42-year-old female presents to her primary care provider complaining of numbness and tingling bilaterally in her hands for the past month. She has a past medical history of Crohn’s disease and underwent ileal resection 2 years ago. Previously, laboratory studies demonstrated glucose intolerance, which has been managed with lifestyle modifications. The patient’s vital signs are T 98.7 F, HR 98, BP 128/76, and O2 Sat 98%. CBC demonstrates a WBC 7.0, Hgb 10.8, Hct 31.1, and MCV 110. The patient’s Hgb A1c is 5.6%. MRI spine is performed, which shows the following finding (Figure A). What is the most likely cause of the patient’s presentation?
Long-term poorly managed diabetes mellitus
New onset of multiple sclerosis
Manifestation of a previously untreated syphilis infection
Consequence of ileal resection
Autoimmune destruction of gastric parietal cells
A 27-year-old man presents to the emergency department for weakness and fatigue. His symptoms started 3 days ago and have been gradually worsening. The patient has a history of poorly managed Crohn disease and currently has a complication being managed by his surgeon. This past month, he has had 4 episodes of severe abdominal pain requiring admission. His temperature is 97.6°F (36.4°C), blood pressure is 114/64 mmHg, pulse is 120/min, respirations are 12/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding in Figure A which is suctioned and cleaned. His abdomen is nontender. Laboratory studies are ordered as seen below.Serum:Na+: 139 mEq/LCl-: 100 mEq/LK+: 3.3 mEq/LHCO3-: 25 mEq/LBUN: 20 mg/dLGlucose: 90 mg/dLCreatinine: 1.4 mg/dLCa2+: 10.2 mg/dLWhich of the following is the most appropriate initial step in management?