nbme Form 4, block 3 - brown911

[ArchivalUser]

4) A 32-yo woman comes to her doctor because of a 1-month history diarrhea, abdominal bloating, and loss of appetite resulting in an 8-lb weight loss. She reports 3 to 4 semi-liquid stools daily. She has no fever, abdominal pain or rectal bleeding. She returned from a scuba diving vacation from Mexico 6-weeks ago; her boyfriend who went with her did not have any symptoms. Abdominal and rectal exam show no abnormalities. Which of the following is the most likely cause?

A) E.coli O157:H7
B) Giardia lamblia
C) Rotavirus
D) Vibrio cholera
E) Yersinia enterocolitica


I marked C) Rotavirus, which is wrong.

Here's my rationale:

I know E.coli O157:H7 and Yersinia give bloody diarrhea, so eliminate them.
Vibrio gives "rice-water" stools (profuse liquid, not semi-liquid)
They didn't mention any foul-smell--- so I thought Giardia is out based on that thinking...

Anyone please help!!!

[ArchivalUser]

Anyone??? Please!

[ArchivalUser]

B-giardia (diarrhea +malabsorption)

[ArchivalUser]

They dont have to mention foul smell (abdominal bloating should suffice)

[ArchivalUser]

@ someguy: thanks for your help and explanation....but really quickly... does Rotavirus cause abdominal bloating at all?

[ArchivalUser]

I dont think so.However ,i chose giardia and i got it right

[ArchivalUser]

Ok, cool! Thanks so much!