How do you dx diarrhea due to bacterial overgrouth - acha

[ArchivalUser]

Attending suspects diarrhea due to bacterial overgrouth/

How do u dix it?

[ArchivalUser]

cipro

[ArchivalUser]

Diagnosis : Negative stool exam and a positive glucose breath test result..

Is cipro the treatment?

[ArchivalUser]

ph stool: acidic
reducing substances in stool: +
3 xylose breath tests +

tx: clinda/genta
metronidazol
dont know about cipro

[ArchivalUser]

92. (QId - 86) A 58-year-old female with a history of diabetes mellitus presents to the family physician for diarrhea, weight loss, bloating, and excess flatulence. She was diagnosed with diabetic enteropathy last year. Laboratory examinations show anemia with MCV of 101 fl. Which of the following is the best test to diagnose bacterial overgrowth in this patient?

A) Quantitative jejunal cultures

B) [14C]-d-xylose breath test

C) Bentiromide test

D) Breath hydrogen analysis

E) Quantitative fecal fat

The correct answer is: A

28% of the people have answered this question correctly

Explanation:

The demonstration of excessive bacterial concentrations in a jejunal aspirate is the gold standard for the diagnosis of bacterial overgrowth. It can be performed during endoscopy or by fluoroscopy with jejunal intubation. The patient"s bacterial overgrowth is most likely due to her diabetic enteropathy.

(Choice B) The Clinical Efficacy Committee of the American College of Physicians also advocates alternate use of one-gram [14C]-d-xylose in routine clinical practice. Xylose is a pentose sugar that is catabolized by gram-negative aerobes present in the intestine, releasing the radioactive isotope 14-CO2, which is detectable in breath samples.

(Choice D) Breath hydrogen testing is performed by the administration of a test dose of carbohydrate, which would be associated with a rise in breath hydrogen levels in patients with bacterial overgrowth.

(Choice C) A bentiromide test is a test for pancreatic insufficiency and not bacterial overgrowth.

(Choice E) Quantitative fecal fat is a test for fat malabsorption, but is not specific for bacterial overgrowth.

Educational Objective:
The gold standard for the diagnosis of bacterial overgrowth is the demonstration of excessive bacterial concentrations in a jejunal aspirate.

[ArchivalUser]

elba

You r in residency.
You must be knowing practical.
This is from UW.

acha please share correct answer.

[ArchivalUser]

carlosaa:
i am right and you are right

all depends in how the questions is written

in your uw questions says " the best test to diagnose bacterial "...then answer is jejunal cultures...in reality you do not go around obtaining jejunal cultures!!!!!!
practical world is differents...but for usmle....we learn the algorithsms.....
and yes jejunal cultures is the best among the choices there....

depends, depends depends...i how the question is written!