Approach to diarrhea (chronic) Quiz: Ace Your Exams

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A 23-year-old woman presents to the emergency department with 2-weeks of worsening diarrhea, abdominal pain, and fatigue. The patient states that she has had diarrhea intermittently for the past 2 months, but that it has recently worsened. She has had more than six loose, bloody stools per day for the past two weeksToday she feels light-headed when standing up. She has not taken medication recently or traveled outside the country. She has no significant past medical history. Temperature is 38.1°C (100.6°F), pulse is 110/min, respirations are 18/min, and blood pressure is 106/64 mmHg. Mucous membranes are dry. Skin turgor is diminished. There is diffuse tenderness to palpation of the abdomenLaboratory results are shown below. Which of the following is the best next step in management? 

 Laboratory test     Result    
 Hemoglobin     10.2 g/dL   
 White blood cell count (WBC)     15,000 /µL   
 Platelets     490,000 /µL   
 C-Reactive Protein (CRP)     50 mg/L   
 Erythrocyte Sedimentation Rate (ESR)     65 mm/hr    

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