1. Question 1
A 25 year-old man comes to your office complaining of frequent bloating, gas, and diarrhea. His diarrhea is non-bloody and he has no associated fevers nor has he lost weight. Stool specimens checked for various infectious organisms all return negative. He notes that his symptoms typically occur shortly after eating ice cream or cheese pizza. You check stool sodium and potassium concentration and calculate the fecal osmotic gap.
Which of the following results for the fecal osmotic gap would you most likely find in this patient?
75 mosm/kg H20
25 mosm/kg H20
140 mosm/kg H20
55 mosm/kg H20
100 mosm/kg H20
For questions #2 and #3, match the most likely cause of diarrhea from the list below.
2. Question 2
A 35 year-old Irish woman with bloating, diarrhea typically after eating, and weight loss comes in. She has an unusual blistering skin rash. Blood tests show that she has an iron-deficiency anemia.
3. Question 3
A 46 year-old man has had non-bloody diarrhea for more than one year. He also has epigastric abdominal pain which prompted an upper endoscopy. This revealed erosive esophagitis and several gastric and duodenal ulcers, some in the second portion of the duodenum.
Bile acid malabsorption
Irritable bowel syndrome