A 78-year-old female patient is suffering from heart failure, GERD, diabetes, and depression. She presents with complaints of frequent episodes of constipation. Her last bowel movement was 1 week ago.
Upon examination, you palpate a hard mass is the left lower quadrant of the abdomen. You review her list of medications. Which of the following of her medications cause constipation?
A. Digitalis (Lanoxin)
B. Amlodipine (Norvasc)
C. Sertraline (Zoloft)
D. Metformin (Glucophage)
Question 2A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and unintentional weight loss. At times he is constipated and other times he has episodes of diarrhea. His physical examination is unremarkable.
It is important for the clinician to recognize the importance of:
A. CBC with differential
B. Stool culture and sensitivity
C. Abdominal x-ray
D. Colonoscopy
Question 3A 20-year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement.
She is on a celiac diet and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with:
A. Inflammatory bowel disease
B. Irritable bowel syndrome
C. Laxative abuse
D. Norovirus gastroenteritis
Question 4A 9-year-old boy accompanied by his mother reports that since he came home from summer camp, he has had fever, nausea, vomiting, severe abdominal cramps and watery stools that contain blood and mucus.
The clinician should recognize the importance of:
A. Stool for ova and parasites
B. Abdominal x-ray
C. Stool for clostridium
D. Fecal occult blood test
Question 5Your 5-year-old female patient presents to the emergency department with sore throat, vomiting, ear ache, 103 degree fever, photophobia, and nuchal rigidity. She has an episode of projectile vomiting while you are examining her.
The clinician should recognize that the following should be done:
A. Abdominal x-ray
B. Fundoscopic examination
C. Lumbar puncture
D. Analysis of vomitus
Question 6Which of the following conditions is the most common cause of nausea, vomiting, and diarrhea?
A. Viral gastroenteritis
B. Staphylococcal food poisoning
C. Acute hepatitis A
D. E.coli gastroenteritis
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