A 24-Year-Old Man Comes to the Emergency Department with a Week

question 560

Multiple Choice

A 24-year-old man comes to the emergency department with a week of abdominal pain.  It is localized in the right lower quadrant and exacerbated somewhat by motion.  Over the past 2 days, the pain has radiated to the back.  The patient initially had 2 episodes of vomiting and now has decreased appetite.  He has no increased urinary frequency.  His other medical problems include mild intermittent asthma and gastroesophageal reflux disease.  One month ago, he traveled to Mexico for 5 days; he had no gastrointestinal symptoms during his stay.  His mother was diagnosed with colon cancer at age 49.  His temperature is 38.2 C (100.8 F) , blood pressure is 122/77 mm Hg, and pulse is 109/min and regular.  Physical examination shows moderate tenderness in the right lower quadrant, without rebound.  Passive extension of the right hip with the patient in the left lateral decubitus position elicits significant abdominal pain.  Laboratory results are as follows: Which of the following is the most likely diagnosis?

• A)Appendiceal abscess
• B)Colonic malignancy
• C)Complicated pyelonephritis
• D)Inflammatory bowel disease
• E)Parasitic colitis

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Definitions:

Contagion Theory

A social theory suggesting that ideas, attitudes, and behaviors spread through groups as if they were infections, influencing individuals to adopt them without conscious realization.

Breakdown Theory

A sociological theory suggesting that social structures may collapse under certain circumstances, leading to social disorder or change.

Anomie

A state of normlessness where societal norms and values are weakened or unclear, leading individuals to feel disconnected from the larger community.

Deprivation

Refers to a state of lacking or denial of basic resources or essentials for human well-being.