A 24-Year-Old Man Comes to the Emergency Department Due to Bloody

question 185

Multiple Choice

A 24-year-old man comes to the emergency department due to bloody diarrhea.  His symptoms began 10 days ago with episodic abdominal discomfort and loose stools.  The symptoms have progressively worsened, and he has had 6-8 stools mixed with blood and mucus over the past 2 days.  The patient recently returned from a 2-week trip to Egypt and felt well while traveling.  Temperature is 38 C (100.4 F) , blood pressure is 120/70 mm Hg, and pulse is 86/min.  The abdomen is soft with mild tenderness on palpation of lower quadrants.  There is no guarding or rebound tenderness, and bowel sounds are hyperactive.  Stool testing is negative for C difficile toxin, and stool culture yields no bacteria.  Sigmoidoscopy reveals colonic ulcers with undermining edges that contain trophozoites.  The causative organism for this patient's current condition can also produce which of the following manifestations?

• A)Bile duct obstruction
• B)Cystic brain lesions
• C)Granulomatous cystitis
• D)Itchy cutaneous eruptions
• E)Liver abscess

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Definitions:

Taijin-Kyofusho

A Japanese culture-specific syndrome characterized by intense fear of offending or harming others through one's social awkwardness or bodily functions.

Social Anxiety

The fear of social situations that involve interaction with other people.

Japanese Psychologist

A professional from Japan specializing in the study of human mind and behavior, employing various methods to understand psychological phenomena.

Attention-Deficit/Hyperactivity Disorder

A neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity that are inappropriate for a person's developmental level.