A 24-Year-Old Man Comes to an Urgent Care Center Because

question 481

Multiple Choice

A 24-year-old man comes to an urgent care center because of a 2 week history of watery diarrhea.  The patient's stools are pale, voluminous, foul smelling, and non-bloody.  He has lost 5 pounds (2.3 kg) over the past week despite eating normally.  He denies fever or abdominal pain, but does admit to bloating and flatulence.  He is an avid hiker, but denies recent travel.
His vital signs are within normal limits.  His abdomen is soft and non-tender with normal bowel sounds.  The remainder of his examination shows no abnormalities.
Laboratory results are as follows:

Which of the following is the most appropriate next step in management?

• A)Absolute eosinophil count
• B)Colonoscopy with biopsies
• C)Fecal fat quantification
• D)Stool microscopy
• E)Tissue transglutaminase IgA antibody

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Definitions:

Lateral Hemispheres

Regions of the cerebellum involved in planning, executing, and learning motor movements.

Fine Motor Coordination

The ability to use small muscles, particularly in the hands and fingers, precisely, often necessary for tasks like writing, typing, and manipulating small objects.

Cerebellar Peduncles

Three pairs of stalk-like structures that connect the cerebellum to the brainstem, involved in movement and posture.

Arbor Vitae

The tree-like structure in the cerebellum made up of white matter, which helps coordinate and regulate muscular activity.