Case review 20056 - Active Lounge

Presenting Complaints

This 69-year-old man gave an 8 year history of intermittent diarrhea, edema and a 20-pound weight loss. He described his stools as foul-smelling and bulky.
No history of arthritis or arthralgias could be elicited. The patient smoked one to two packs of cigarettes a day and mentioned an occasional drink.
Following a non diagnostic malabsorption workup he had been placed on kaopectate, paregoric, folic acid, and a gluten-free diet. In addition, the presence of a nonspecific pancytopenia had prompted his physicians to place him on 20 mg.

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Q 1 : The most common parasitic worm found within the appendiceal lumen is Enterobius vermicularis 10115 845292005610115 12

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Presenting Complaints View Detail

Clinical Findings

The patient was noted to be a cachectic white man who appeared older than his stated age. Pertinent findings included mesenteric lymphadenopathy.

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Q 1 : The small bowel morphology is diagnosic of 10112 845292005610112 16

Non-tropical sprue
Regional enteritis
Intestinal lymphoma
Whipple's disease

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Regional enteritis

Morphologically, the proximal bowel is usually the most severely affected.... More

0 %

Intestinal lymphoma

Primary intestinal lymphomas may be seen in all age groups but tend to predominate in midd... More

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Whipple's disease

A peculiar variant of primary intestinal lymphoma is present in Arabs, and Middle Eastern ... More

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Clinical Findings View Detail

Physical Examination

The patient was noted to be a cachectic white man who appeared older than his stated age. Pertinent findings included mesenteric lymphadenopathy.

Physical Examination

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Physical Examination View Detail

Lab Results

Detail

1. Hemoglobin fractionation and quantitation, electrophoresis (eg, A2, S, C, and/or F)
on 05 Dec 17

Description: Evaluation of peripheral smer: Erythrocytes were microcytic and hypochromic.

Test Component

Test Value

Hemoglobin fractionation and quantitation, electrophoresis (eg, A2, S, C, and/or F)

7.3 gm/dl %

Lab Results

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Q 1 : Proper therapy at this juncture should consist of correction of her iron deficiency anemia and prescription of a stronger stimulant type laxative with supplemental saline cathartics as needed 10113 845292005610113 17

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Radiology Results

Detail
1. Radiologic examination, colon, contrast (eg, barium) enema, with or without KUB; on 06 Dec 17 Description: No significant abnormality.

Radiology Results

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Q 1 : The black stools of patients taking oral ferrous sulfate will give a false postive guaiac 10114 845292005610114 18

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Differential Diagnosis

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Treatment Approach

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Medication

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Medical Course/Hospital Stay

Medical Course Name
1. Clinical impression upon admission was that of an acute exacerbatiojn of chronic relapsing pancreatitis. on 06 Dec 17

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Q 1 : The most common primary neoplasm of the appendix is a carcinoid 10117 845292005610117 23

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Q 1 : The most common parasitic worm found within the appendiceal lumen is Enterobius vermicularis 10115 845292005610115 12

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Q 1 : Although the mortality and morbidity has declined sharply over the last 50 years, the incidence of acute appendicitis has remained relatively stable 10116 845292005610116 13

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Q 1 : The small bowel morphology is diagnosic of 10112 845292005610112 16

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1. Hemoglobin fractionation and quantitation, electrophoresis (eg, A2, S, C, and/or F)

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Q 1 : Proper therapy at this juncture should consist of correction of her iron deficiency anemia and prescription of a stronger stimulant type laxative with supplemental saline cathartics as needed 10113 845292005610113 17

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1. Radiologic examination, colon, contrast (eg, barium) enema, with or without KUB;

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Q 1 : The black stools of patients taking oral ferrous sulfate will give a false postive guaiac 10114 845292005610114 18

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1. Clinical impression upon admission was that of an acute exacerbatiojn of chronic relapsing pancreatitis.

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Q 1 : The most common primary neoplasm of the appendix is a carcinoid 10117 845292005610117 23

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