A 16-year-old male with no significant past medical, surgical, or family history presents to his pediatrician with new symptoms following a recent camping trip. He notes that he went with a group of friends and 1 other group member is experiencing similar symptoms. Over the past 5 days, he endorses significant flatulence, nausea, and greasy, foul-smelling diarrhea. He denies tenesmus, urgency, and bloody diarrhea. The blood pressure is 118/74 mm Hg, heart rate is 88/min, respiratory rate is 14/min, and temperature is 37.0°C (98.6°F). Physical examination is notable for mild, diffuse abdominal tenderness. He has no blood in the rectal vault. What is the patient most likely to report about his camping activities?
AThe patient camped as a side excursion from a cruise ship.
BThe patient camped in Mexico.
CThis has been going on for months.
DRecent antibiotic prescription
ECollecting water from a stream, without boiling or chemical treatment
A 32-year-old woman comes to the emergency department with a 2-day history of abdominal pain and diarrhea. She has had about 8 voluminous stools per day, some of which were bloody. She visited an international food festival three days ago. She takes no medications. Her temperature is 39.5°C (103.1°F), pulse is 90/min, and blood pressure is 110/65 mm Hg. Examination shows a tender abdomen, increased bowel sounds, and dry mucous membranes. Microscopic examination of the stool shows polymorphonuclear leukocytes. Stool culture results are pending. Which of the following most likely caused the patient's symptoms?
AHome-canned vegetables
BYogurt dip
CReheated rice
DToxic mushrooms
EOmelette
A 31-year-old man comes to the physician because of a 2-day history of abdominal pain and diarrhea. He reports that his stools are streaked with blood and mucus. He returned from a vacation in the Philippines 3 weeks ago. His vital signs are within normal limits. Abdominal examination shows hyperactive bowel sounds. A photomicrograph of a trichrome-stained wet mount of a stool specimen is shown. Which of the following organisms is the most likely cause of this patient's symptoms?
ACampylobacter jejuni
BGiardia lamblia
CCryptosporidium parvum
DShigella dysenteriae
EEntamoeba histolytica
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