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MMLU / A 52-year-old woman comes to the emergency department because of a 1-week…

Problem

Answer published by the source. Consult the official source to check your work against its answer.

question

A 52-year-old woman comes to the emergency department because of a 1-week history of low-grade fever and increasing abdominal cramps that are exacerbated by bowel movements. She began a course of amoxicillin-clavulanate and metronidazole 2 days ago but has had no relief of her symptoms. She has had intermittent constipation for the past 12 years. She has not had nausea, vomiting, urinary symptoms, or bloody stools. She has a 3-year history of hypertension. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy 5 years ago because of leiomyomata uteri. She is 165 cm (5 ft 5 in) tall and weighs 86 kg (190 lb); BMI is 32 kg/m2 . Her temperature is 38.1°C (100.6°F), pulse is 75/min, and blood pressure is 150/80 mm Hg. The lungs are clear to auscultation. Cardiac examination shows no abnormalities. The abdomen is soft, and there is tenderness to palpation of the left lower quadrant with guarding but no rebound. Bowel sounds are normal. The stool is brown, and test for occult blood is negative. Her hemoglobin concentration is 14.5 g/dL, leukocyte count is 15,000/mm3 , and platelet count is 280,000/mm3 ; serum studies and urinalysis show no abnormalities. Which of the following is the most appropriate next step in diagnosis?

choices

  1. Test of the stool for Clostridium difficile toxin
  2. Endoscopic retrograde cholangiopancreatography
  3. Pelvic ultrasonography
  4. CT scan of the abdomen with contrast

subject

professional_medicine

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Source and history

task_id
11b55996-6c9b-551b-b978-18d6234573aa
task_key
all--test--11b55996-6c9b-551b-b978-18d6234573aa
task_revision_id
1
config / split
all / test

Official source

initial import