Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in the stool. She works in a day care center and has not traveled recently or had exposure to antibiotics. She is otherwise healthy and takes no medications.
On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 112/74 mm Hg, and pulse rate is 70/min. The abdomen is soft with normal bowel sounds and mild distention but no tenderness.
Which of the following is the most appropriate management?
A. Colonoscopy
B. Stool cultures
C. Stool testing for ova and parasites
D. No further testing
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