Question 1 (1 point)
A 42-year-old florist comes to your office, complaining of chronic constipation for the last
six months. She has had no nausea,
... [Show More] vomiting, or diarrhea, and no abdominal pain or cramping.
She denies any recent illnesses or injuries. She denies any changes to her diet or exercise
program. She is on no new medications. During the review of systems (ROS), you note that she
has felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past
medical history is significant for one vaginal delivery and two cesarean sections. She is married,
has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother
has type 2 diabetes and her father has coronary artery disease. There is no family history of
cancers. On examination, she appears her stated age. Her vital signs are normal. Her head, eyes,
ears, nose, throat, and neck examinations are normal. Her cardiac, lung, and abdominal
examinations are also unremarkable. Her rectal occult blood test is negative. Her deep tendon
reflexes are delayed in response to a blow with the hammer, especially the Achilles tendons.
What is the best choice for the cause of her constipation?
Question 2 (1 point)
A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation,
and a low-grade fever for about three days. He denies any nausea, vomiting, or diarrhea. The
only unusual thing he remembers eating is two bags of popcorn at the movies with his grandson,
three days before his symptoms began. He denies any other recent illnesses. His past medical
history is significant for coronary artery disease and high blood pressure. He has been married
for over fifty years. He denies any tobacco, alcohol, or drug use. His mother died of colon cancer
and his father had a stroke. On examination, he appears his stated age and is in no acute distress.
His temperature is 100.9 degrees and his other vital signs are unremarkable. His head, cardiac,
and pulmonary examinations are normal. He has normal bowel sounds and is tender over the left
lower quadrant. He has no rebound or guarding. His rectal examination is unremarkable and his
fecal occult blood test is negative. His prostate is slightly enlarged but his testicular, penile, and
inguinal examinations are all normal. Blood work is pending.
What diagnosis for abdominal pain best describes his symptoms and signs?
Question 2 options [Show Less]