A 25-year-old male presents with an 18-month history of chro…
A 25-year-old male presents with an 18-month history of chronic abdominal pain. The patient has seen several providers and has been diagnosed as having ‘nervous stomach’, irritable bowel syndrome, and depression. Associated with this abdominal pain for the last 3 months have been non-bloody diarrhea, anorexia, and a weight loss of 20 lbs. On exam, the patient has diffuse abdominal tenderness. He looks thin and unwell. He has a tender, erythematous area in the right perirectal area suggestive of a rectal abscess. What is the most likely diagnosis?
Read DetailsA 25-year-old male presents with an 18-month history of chro…
A 25-year-old male presents with an 18-month history of chronic abdominal pain. The patient has seen several providers and has been diagnosed as having ‘nervous stomach’, irritable bowel syndrome, and depression. Associated with this abdominal pain for the last 3 months have been non-bloody diarrhea, anorexia, and a weight loss of 20 lbs. On exam, the patient has diffuse abdominal tenderness. He looks thin and unwell. He has a tender, erythematous area in the right perirectal area suggestive of a rectal abscess. Which lab work has the best predictive value for clarifying this diagnosis?
Read DetailsAccording to the National Kidney Foundation (NKF), referrals…
According to the National Kidney Foundation (NKF), referrals to the nephrologist should be done for which of the following reason(s): In addition to referral of all patients who have an eGFR less than 30ml/min per 1.73m2, patients with CKD who meet one or more of the following criteria be referred to a nephrologist. Which of the conditions below (#1 to #7) should he referred to nephrology? 1. Urine albumin-to-creatinine ratio (ACR) 300mg/g (34mg/mmol), including nephrotic syndrome 2. Hematuria not secondary to urologic conditions 3. Inability to identify a presumed cause of CKD 4. eGFR decline of more than 30% in fewer than four months without an obvious explanation 6. Patients under the age of 18 years 7. Resistant hypertension 8. Recurrent or extensive nephrolithiasis 7. Resistant hypertension
Read DetailsA 25-year-old male presents with an 18-month history of chro…
A 25-year-old male presents with an 18-month history of chronic abdominal pain. The patient has seen several providers and has been diagnosed as having ‘nervous stomach’, irritable bowel syndrome, and depression. Associated with this abdominal pain for the last 3 months have been non-bloody diarrhea, anorexia, and a weight loss of 20 lbs. On exam, the patient has diffuse abdominal tenderness. He looks thin and unwell. He has a tender, erythematous area in the right perirectal area suggestive of a rectal abscess. Which of the following drugs is/are appropriate initial therapy in the acute phase of the condition described in this case? 1. corticosteroids such as budesonide 2. antibiotics such as metronidazole 3. probiotics 4. 5-ASA such as Pentasa or Asacol
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