Week 1
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Quiz 1 Context:
A 72-year-old diabetic female is admitted to the medical ICU with a diagnosis of urosepsis. Over the next 10 days her condition improves with fluid resuscitation and intravenous antibiotics. Subsequently she again begins to deteriorate, with the development of severe diarrhea, fevers, leukocytosis, and abdominal pain. Repeat blood and urine cultures are negative. A CT scan of the abdomen is performed and is shown to the right.
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c. Excellent!
The CT scan reveals thickening of the wall of the cecum consistent with colitis — in this case, C difficile colitis most likely related to exposure to antibiotics. Antibiotic-associated diarrhea remains the most common cause of diarrhea in the hospitalized patient.
You have correctly identified this week's Image of the Week. Now test your knowledge of antibiotic associated diarrhea. For example, do you know .....
....C difficile is considered part of the normal flora of a certain group of patients. Which group?
....what is the sensitivity of the enzyme-linked immunosorbent assay for C difficile toxin, and why is this test preferred over the latex agglutination test?
...the six conditions for which the current guidelines from the American College of Gastronterology recommend oral vancomycin for the treatment of C difficile colitis?
The answers to these questions, and a concise review of the pathogenesis, diagnosis, and treatment of antibiotic-associated diarrhea, can be found here within the Cleveland Clinic Disease Management Project.
This CT Scan is most consistent with which of the following?
- Appendicitis
- Perinephric abscess
- Colitis
- Splenic infarction
- Aorto-enteric fistula
