05-21-2007, 04:21 AM
A 3-week-old white female who is being fed a formula with a cow's milk base is brought to your office with a 4-day history of dark blood flecks in otherwise normal appearing stools. Other history is unremarkable. A physical examination reveals yellow, curdy, guaiac-positive stool. Anal and rectal examinations are normal, as is the rest of the examination.
The best course of action would be to
draw blood for CBC, BUN, and electrolytes, and start intravenous fluids
culture the stool for rotavirus
obtain upper and lower GI barium fluoroscopy studies
perform an alkali denaturation test on the stool to rule out a maternal source for the blood
suggest a change to a soy-based formula
The best course of action would be to
draw blood for CBC, BUN, and electrolytes, and start intravenous fluids
culture the stool for rotavirus
obtain upper and lower GI barium fluoroscopy studies
perform an alkali denaturation test on the stool to rule out a maternal source for the blood
suggest a change to a soy-based formula