Gastrointestinal System


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F1.jpg"}},{"insert":"\n\n"},{"insert":"\u0022What a beautiful morning,\u0022 you think as you stroll through the parking lot of your hospital. Feeling that the day is off to a great start, you walk in through the automatic doors, only to be greeted by a scene of pandemonium.\n\nBefore you have time to regain your senses, the head nurse rushes at you and slaps a medical record into your hands. \u0022Oh, thank goodness you are here, doctor! The clinic is overflowing with diarrhea!\u0022\n\nBefore you can make head or tail of her words, you are almost shoved into an exam room. \u0022So much for the great start to the day,\u0022 you sigh and take a look at the first patient.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F2.jpg"}},{"insert":"\n\n"},{"insert":"Pamela is a 31-year-old mother of 2 children. She is currently in the 27th week of gestation of her 3rd pregnancy. She has experienced projectile vomiting, watery diarrhea, and mild abdominal pain for the last 2 days. On average, she experienced between 6 to 8 bowel movements each day.\n\nOn close questioning, she states that she almost always eats food prepared by herself at home, with the sole exception being a plate of food she had at a dinner party around one week ago. She has not traveled anywhere recently.\n\nOn examination, she is mildly dehydrated, with a temperature of 98.9\u02daF (37.1\u02daC), pulse rate of 78 bpm, blood pressure of 112\/78 mmHg, and respiratory rate of 12\/min. Aside from this, your thorough clinical examination (including an obstetric assessment) reveals no abnormal findings.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F4.jpg"}},{"insert":"\n\n"},{"insert":"Pamela\u0027s stool analysis shows the following results:\n\nWhite cells: 3\/hpf \r\nRed cells: 1\/hpf\nGram stain: gram-negative curved rods\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M59_F3.jpg"}},{"insert":"\n\n"},{"insert":"You realize that Pamela should be started on oral rehydration therapy. However, you ponder if this alone will be sufficient.\n\nWhat will you do?\n"}]}
1. Prescribe nothing more
2. Start Ciprofloxacin as well
3. Start Azithromycin as well