USMLE Forum Archives - USMLE Step 2 CK - Long standing crampy abdominal pain
Long standing crampy abdominal pain
laparotomy - 02-25-08 09:05
A 25 year old femal presents to you with a 3 year history of crampy abdominal pain with diarrea getting worse in the last 6 months. She states she takes vitamin B12 for anaemia. What is you diagnosis and next step in management?
laparotomy - 02-25-08 09:05
A 25 year old femal presents to you with a 3 year history of crampy abdominal pain with diarrea getting worse in the last 6 months. She states she takes vitamin B12 for anaemia. What is you diagnosis and next step in management?
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#1
Re: Long standing crampy abdominal pain radhamesramos - 02-25-08 09:59 Did she travel outside the U.S previous to that? Any blood in the feces?
It can Crohn's disease in the small bowel
#2
Re: Long standing crampy abdominal pain TheOne - 02-25-08 12:37 IBS, IBD.. Stool Analysis as a next step.
#3
Re: Long standing crampy abdominal pain
laparotomy - 02-26-08 02:54 
posted by TheOne on 02-25-08 12:37
IBS, IBD.. Stool Analysis as a next step.
IBS, IBD.. Stool Analysis as a next step.
If stool samples come back normal then what?
#4
Re: Long standing crampy abdominal pain TheOne - 02-26-08 11:44 CBC, Lytes, LFT, RFT and consider Colonoscopy if the results are NL.
#5
Re: Long standing crampy abdominal pain agamamber - 02-26-08 12:31 what is the diagnosis?plz tell.
#7
Re: Long standing crampy abdominal pain laparotomy - 02-26-08 16:17 posted by agamamber on 02-26-08 12:31
what is the diagnosis?plz tell.
what is the diagnosis?plz tell.
Can I answer a question with a question?
So my question is, why would she be taking B12. Is that an important fact or just an incidental finding?
#8
Re: Long standing crampy abdominal pain radhamesramos - 02-27-08 12:53 Probably she has megaloblastic anemia....if she has long standing Crohn's disease in the distal ileum she has might impaired absorption of vitamin B12
#10
Re: Long standing crampy abdominal pain laparotomy - 02-28-08 03:33 posted by radhamesramos on 02-27-08 12:53
Probably she has megaloblastic anemia....if she has long standing Crohn's disease in the distal ileum she has might impaired absorption of vitamin B12
Probably she has megaloblastic anemia....if she has long standing Crohn's disease in the distal ileum she has might impaired absorption of vitamin B12
Exactly. So I think your answer answers the most likely diagnosis question.
The next question is what will you do?
A. Treat for Crohns
B. Do diagnostic tests to confirm your diagnosis
C. Treat and at the same time b. above
If you choose B or C what are those tests?
If you choose A then how will you treat? With what drugs? Or will you do a total colectomy with ileal resection?
#11
Re: Long standing crampy abdominal pain ammulufy - 06-28-10 21:07 I wud like to do certain diagnostic tests like enteroscopy,biopsy d lesion......n proceed on with the treatment.
#12
Re: Long standing crampy abdominal pain babbu5508 - 06-29-10 02:59 i think it's b12 deficiency due to terminal ileitis..the crohns... confirm the diagnosis with endoscopy and treat with aminosalicylate anti-inflammatory drugs and corticosteroids
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