CONSTIPATION/DIARRHEA

Question 1

Colorectal cancer DDx:

4

Answer 1

1. IBS.
2. Diverticulosis.
3. GI parasitic infection (ascariasis, giardiasis).
4. IBD.

Question 2

Colorectal cancer workup:

7

Answer 2

1. Rectal exam, stool for occult blood.
2. CBC.
3. Electrolytes.
4. AST/ALT/bil/ALP.
5. Colonoscopy.
6. Barium enema.
7. CT abdo/pelvis.

Question 3

Low-fiber diet DDx:

4

Answer 3

1. Depression.
2. Substance abuse (eg heroin).
3. IBS.
4. Hypothyroidism.

Question 4

Low-fiber diet workup:

4

Answer 4

1. Rectal exam.
2. TSH.
3. Electrolytes.
4. Urine tox.

Question 5

IBS DDx:

5

Answer 5

1. IBD.
2. Celiac disease.
3. Chronic pancreatitis.
4. GI parasitic infection (ascariasis, giardiasis).
5. Lactose intolerance.

Question 6

IBS workup:

6

Answer 6

1. Rectal exam, stool for occult blood.
2. CBC.
3. Electrolytes.
4. Colonoscopy.
5. Stool for ova and parasitology.
6. CT abdo/pelvis.

Question 7

Infectious diarrhea (gastroenteritis) DDx:

2

Answer 7

1. Bacterial — viral — parasitic — protozoal.

2. Food poisoning.

Question 8

Infectious diarrhea workup:

5

Answer 8

1. Rectal exam, stool for occult blood.
2. Stool leukocytes and culture.
3. CBC.
4. Electrolytes.
5. CT abdo/pelvis.

Question 9

Pseudomembranous colitis DDx:

4

Answer 9

1. Gastroenteritis.
2. Cryptosporidiosis.
3. Food poisoning.
4. IBD.

Question 10

Pseudomembranous colitis workup:

5

Answer 10

1. Stool for C.diff toxin.
2. Rectal exam, stool for occult blood.
3. Stool leukocytes and culture.
4. CBC.
5. Electrolytes.

Question 11

Traveler’s diarrhea DDx:

4

Answer 11

1. Giardiasis.
2. Amebiasis.
3. Food poisoning.
4. Hep A.

Question 12

Traveler’s diarrhea workup:

6

Answer 12

1. Rectal exam.
2. Stool leukocytes, culture, Giardia antigen, Entamoeba histolytica antigen.
3. CBC.
4. Electrolytes.
5. AST/ALT/bil/ALP.
6. Viral hep.

Question 13

Lactose intolerance DDx:

4

Answer 13

1. Gastroenteritis.
2. IBD.
3. IBS.
4. Hyperthyroidism.

Question 14

Lactose intolerance workup:

4

Answer 14

1. Rectal exam.
2. Stool leukocytes and culture.
3. Hydrogen breath test.
4. TSH.

Question 15

Crohn disease DDx:

7

Answer 15

1. Gastroenteritis.
2. UC.
3. Celiac disease.
4. Pseudomembranous colitis.
5. Hyperthyroidism.
6. Small bowel lymphoma.
7. Carcinoid syndrome.

Question 16

Crohn disease workup:

9

Answer 16

1. Rectal exam, stool for occult blood.
2. Stool leukocytes and culture.
3. CBC.
4. Electrolytes.
5. Colonoscopy.
6. CT abdo.
7. TSH.
8. Small bowel series.
9. 5-HIAA.