A 40 year-old female presents to the office with the chief complaint of diarrhea.

Case Study 2

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A 40 year-old female presents to the office with the chief complaint of diarrhea. She has been having recurrent episodes of abdominal pain, diarrhea, and rectal bleeding. She has lost 9 pounds in the last month. She takes no medications, but is allergic to penicillin. She describes her life as stressful, but manageable. The physical exam reveals a pale middle- aged female in no acute distress. Her weight is 140 pounds (down from 154 at her last visit over a year ago), blood pressure of 94/60 sitting and 86/50 standing, heart rate of 96 and regular without postural changes, respiratory rate of 18, and O2 saturation 99%. Further physical examination reveals:

Skin: w/d, no acute lesions or rashes

Eyes: sclera clear, conj pale

Ears: no acute changes

Nose: no erythema or sinus tenderness

Mouth: membranes pale, some slight painful ulcerations, right buccal mucosa, tongue beefy red, teeth good repair

Neck: supple, no thyroid enlargement or tenderness, no lymphadenopathy

Cardio: S1 S2 regular, no S3 S4 or murmur

Lungs: CTA w/o rales, wheezes, or rhonchi

Abdomen: scaphoid, BS hyperactive, generalized tenderness, rectal +occult blood

• Think about a differential diagnosis. Consider the role the patient history and physical exam played in diagnosis.
• Reflect on potential treatment options based on your diagnosis.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study that you selected. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis.

Please make sure to reference

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.