Full Answer Section

Additional Objective Findings

I would also look for:

• Dehydration: Signs of dehydration, such as dry mucous membranes, decreased skin turgor, and decreased urine output.
• Abdominal tenderness or guarding: More localized abdominal pain or tenderness, especially in the right lower quadrant, which could suggest appendicitis.
• Rectal examination: To assess for any abnormalities, such as hemorrhoids, fissures, or masses.
• Stool examination: To test for blood, parasites, or other abnormalities.

Diagnostic Exams

Based on the patient’s symptoms, I would order the following diagnostic tests:

• Complete blood count (CBC): To evaluate for anemia, infection, or other blood disorders.
• Comprehensive metabolic panel (CMP): To assess electrolyte balance and kidney function.
• Stool culture: To identify any bacterial or parasitic infections.
• Stool test for occult blood: To check for bleeding in the gastrointestinal tract.
• Thyroid function tests: To rule out thyroid disorders that can cause diarrhea.

Differential Diagnoses

Based on the patient’s presenting symptoms, three possible differential diagnoses include:

1. Acute gastroenteritis: A common cause of diarrhea, often caused by viral or bacterial infections.
   • Rationale: The patient’s symptoms of frequent, watery stools, fever, chills, and loss of appetite are consistent with acute gastroenteritis.
2. Irritable bowel syndrome (IBS): A functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits.
   • Rationale: While IBS can present with diarrhea, the patient’s symptoms are more consistent with an acute illness rather than a chronic condition like IBS.

    
3. Inflammatory bowel disease (IBD): A group of chronic inflammatory diseases of the gastrointestinal tract, including Crohn’s disease and ulcerative colitis.
   • Rationale: While IBD can cause diarrhea, the patient’s symptoms are more acute and do not suggest the chronic inflammation associated with IBD.