A 56-Year-Old Man Comes to the Office for Evaluation of Diarrhea

question 399

Multiple Choice

A 56-year-old man comes to the office for evaluation of diarrhea.  He has had 6 or 7 loose, watery brown stools every day for the past 4 weeks as well as frequent nocturnal episodes while sleeping.  The patient has no fever, hematochezia, melena, unexpected weight loss, or abdominal pain.  He was discharged from the hospital 5 weeks ago after a protracted stay for emphysematous cholecystitis complicated by intraabdominal abscess, which required an emergency cholecystectomy and abscess drainage as well as broad-spectrum intravenous antibiotics.  Medical history is significant for morbid obesity, hypertension, and hyperlipidemia.  There has been no change in the patient's home medications.  Temperature is 37.4 C (99.3 F) , blood pressure is 145/80 mm Hg, pulse is 80/min, and respirations are 13/min.  Sclera are anicteric, and mucous membranes are moist.  Surgical scars on the abdomen are well healed, and the abdomen is nontender and nondistended.  Laboratory results are as follows: Stool is negative for occult blood and leukocytes.  Test of the stool for Clostridioides difficile toxin is negative.  Erythrocyte sedimentation rate is normal.  What is the most appropriate next step in management of this patient?

• A)Budesonide
• B)Cholestyramine
• C)Lactose-free diet
• D)Oral vancomycin
• E)Pancreatic enzyme replacement therapy
• F)Sulfasalazine

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Definitions:

Conflict Resolution

Techniques and strategies used to resolve disagreements or disputes in a constructive manner, aiming for mutual agreement or understanding.

Communication

The exchange of information, thoughts, messages, or feelings between individuals through various channels.

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Undesirable results or effects that can arise from a process, decision, or event.

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