DrVirgo
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10. An 86-year-old woman with hypertension, non-insulin dependent diabetes, coronary artery disease, and a history of a tonsillectomy as a child comes to the office because of 1-week of watery diarrhea. She has been in relatively good health except for a tooth infection for which she had recently completed a 14-day course of clindamycin. She reports some subjective fevers and chills but denies significant abdominal pain. Her temperature is 38.0 C (100.4 F), blood pressure is 110/70 mm Hg, pulse is 95/min, and respirations are 12/min. Physical examination shows dry mucous membranes, anicteric sclera, mild left lower quadrant tenderness without rebound or guarding. Bowel sounds were increased. Rectal examination is heme negative without obvious masses. The finding that will most likely establish the most likely diagnosis is
a) Angiography revealing decreased flow to the superior mesenteric artery
b) Detailed travel history and exposure to people with similar illness
c) Obstruction series showing dilated loops of small bowel with air fluid levels
d) Sigmoidoscopy showing diffuse friability, pseudopolyps, ulcerations, and bleeding
e) Stool examination positive for a bacterial toxin
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| sarika
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e for clostridium difficle toxin
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| ndspider
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E. Good Question,
I almost went with superior mesenteric ischemia but that would show blood and pain.
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| robin082006
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E
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| DrVirgo
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E. right. toxin for c. diff
-Antibiotic associated pseudomembranous colitis?
What other antibiotics besides clindamycin do this?
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| robin082006
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AMOXICILLIN, AMPICILLIN
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| AAAAA
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E
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seeking study partner in USMLE, Canadian MCC OSCE examination
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