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He was in good health until 6 weeks ago when he developed intermittent watery diarrhea, occurring six times per day, with frequent nocturnal episodes. He has abdominal cramping. His symptoms improve with fasting. He does not have fevers, chills, night sweats, nausea, vomiting, or arthralgias, but has recently lost 2.7 kg (6 Ib). He has had no recent travel or sick contacts.
Physical examination shows a papulovesicular eruption on the lower back and left elbow. Abdomen is soft, but there is no organomegaly. Stool is light brown and negative for occult blood.
Which of the following tests would establish the diagnosis?
A. Examination for ova and parasites
B. HIV test
C. Flexible sigmoidoscopy
D. 24 Hour fecal fat collection
E. Small-bowel biopsy


b ????


I thought its E. celiac sprue. NOT sure.


papulovesicular rash???? doesnt it means shingles????




i was confusing dermatitis herpetiformis lesions as shingles!!!!sticking out tongue

definately E!!!


I also think its E , it looks like Celiac Spru (at least with th "symptoms improve with fasting and the dermatitis herpetiform rash" clues).

So what was the answer eggyolk?


dermatitis herpetiformis is frequently linked to gluten sensitivity (celiac sprue disease) in the small bowel.


So ans should be E only.


good question..thats celiac sprue with dematitis herpetiformis.grin

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