USMLE Question of the Week
Diarrhea and Sub-Acute Abdominal Pain in a Young Male
In Episode 24 of Med School Question of the Week for USMLE, Alisa Khomutova, MedSchoolCoach expert tutor, answers this medical school question:
A 35-year-old-man comes to the ER because of a 3-month history of intermittent abdominal pain associated with diarrhea, bloating, and mild nausea. During this period, he has had a 5-kg (11-lb) weight loss. He feels like he cannot fully empty his bowels. He consumes a high-fiber diet. On physical exam, his temperature is 36.9ºC (98.5ºF), pulse is 90/min, and blood pressure is 130/90 mm Hg. Pulmonary and cardiac exams are unremarkable. Abdominal examination shows mild tenderness to palpation in the right lower quadrant without guarding or rebound. Bowel sounds are normal. Rectal exam is normal. Stool occult blood test is negative. His hemoglobin concentration is 11, WBC count is 12,000 and ESR is 131 mm/h. A barium enema shows ulceration and narrowing of the right colon. Which of the following is the most likely diagnosis
- Diverticulitis
- Ulcerative Colitis
- Crohn Disease
- Irritable Bowel Syndrome
- Carcinoid Tumor
- Celiac Disease