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Name: Instructor’s Name: Course: Date of Submission: 1. What information do you want to illicit in a patient with diarrhea? Information that could help to distinguish between irritable bowel disease and inflammation/neoplasia should be sought whenever a patient shows up with diarrhea.
Risk factors, for example, recent use of antibiotics should also be considered to exclude any bacterial or viral infections that could lead to diarrhea. 2. What physical findings and risks factors are important in this patient? Appearance of blood in the diarrheal stool is the main risk factor in a patient of inflammatory bowel disease as the mucosal membrane is ulcerated. According to the patent there are nocturnal bowel movements which are almost never seen in irritable bowel syndrome. Recent smoking cessation could also be an additional risk factor as cigarette is supposed to protect the mucosal membrane against ulcers. The patient has been using NSAIDs (ibuprofen) recently and the prolong use of these drugs usually causes ulcers. The patient also has a family history of ulcers which makes her genetically predisposed to the disease. On physical examination, the patient appeared slim; signs of weight loss were prominent. The oral mucosa was dry. The heart rate was increased. There was also mild tenderness in the abdomen. All the signs of inflammatory disease, including fever, were present. 3. What are the indications for endoscopy in a patient presenting with diarrhea? Patients presenting with chronic diarrhea are usually suggested for flexible sigmoidoscopy or colonoscopy. ...
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