Overflowing I

Gastrointestinal System


0

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F1.jpg"}},{"insert":"\n\n"},{"insert":"\u0022What a beautiful morning\u0022, you think as you stroll through the parking lot of your hospital.\r\n\r\nFeeling that the day is off to a great start, you walk in through the automatic doors, only to be greeted by a scene of pandemonium.\n\nBefore you have time to regain your senses, the head nurse rushes at you and slaps a medical record into your hands.\n\n\u0022Oh, thank goodness you are here, doctor! The clinic is overflowing with diarrhea!\u0022.\r\n\r\nBefore you can make head or tail of her words, you are almost shoved into an exam room.\n"}]}

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{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F2.jpg"}},{"insert":"\n\n"},{"insert":"\u0022So much for the great start to the day\u0022, you sigh and take a look at the first patient.\n\nPamela is a 31-year-old mother of 2 children. She is currently in the 27th week of gestation of her 3rd pregnancy.\n"}]}

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{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F3.jpg"}},{"insert":"\n\n"},{"insert":"Pamela has experienced projectile vomiting, watery diarrhea, and mild abdominal pain for the last 2 days. On average, she experienced between 6 to 8 bowel movements each day.\n\nOn close questioning, she states that she almost always eats food prepared by herself at home, with the sole exception being a plate of food she had at a dinner party around one week ago.\n\nOn examination, she is mildly dehydrated, with a pulse rate of 78\/min and a blood pressure of 112\/78 mmHg.\r\n\r\nAside from that, your thorough clinical examination (including an obstetric assessment) reveals no abnormal findings.\n"}]}

3

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F4.jpg"}},{"insert":"\n\n"},{"insert":"Her stool analysis shows the following results:\r\n\r\nWhite cells: 3\/hpf\r\nRed cells: 1\/hpf\r\nGram stain: gram-negative curved rods suggestive of C. jejuni\n\nYou realize that Pamela should be started on oral rehydration therapy.\r\n\r\nHowever, you ponder if this alone will be sufficient...\n"}]}

4

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F3.jpg"}},{"insert":"\n\n"},{"insert":"What will you do?\n"}]}
1. Prescribe nothing more
2. Prescribe a fluoroquinolone as well
3. Start erythromycin as well

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