A 9-year-old boy accompanied by his mother reports that since he ...

[CORALGRILL2014]

A 9-year-old boy accompanied by his mother reports that since he came home from summer camp, he has had fever, nausea, vomiting, severe abdominal cramps and watery stools that contain blood and mucus.
 
  The clinician should recognize the importance of:
  A. Stool for ova and parasites
  B. Abdominal x-ray
  C. Stool for clostridium
  D. Fecal occult blood test

Question 2

Your 5-year-old female patient presents to the emergency department with sore throat, vomiting, ear ache, 103 degree fever, photophobia, and nuchal rigidity. She has an episode of projectile vomiting while you are examining her.
 
  The clinician should recognize that the following should be done:
  A. Abdominal x-ray
  B. Fundoscopic examination
  C. Lumbar puncture
  D. Analysis of vomitus

[Koolkid240]

Answer to Question 1

ANS: A
Parasites causing diarrhea usually enter the body through the mouth. They are swallowed and can remain in the intestine or burrow through the intestinal wall and invade other organs. Certain parasites, most commonly Giardia lamblia, transmitted by fecally contaminated water or food, can cause diarrhea, bloating, flatulence, cramps, nausea, anorexia, weight loss, greasy stools because of its interference with fat absorption, and occasionally fever. Symptoms usually occur about 2 weeks after exposure and can last 2 to 3 months. Often, the symptoms are vague and intermittent, which makes diagnosis more difficult. Serial stool samples for O&P should be ordered because a single sample may not reveal the offending parasite.

Answer to Question 2

ANS: C
The range of neurologic disorders that result in nausea and/or vomiting is broad. Included are meningitis, increased intracranial pressure (ICP), migraines, a space-occupying lesion, and Mnire's disorder. Central nervous system-related vomiting is often projectile and may not be preceded by nausea. Papilledema may accompany increased ICP. Neurological deficits may be evident with increased ICP, space-occupying lesions, and meningitis. Nuchal rigidity is a classic finding for meningitis.

[CORALGRILL2014]

Excellent

[nanny]

Gracias!