Travel + self-limiting watery or brown/green diarrhea → Traveler diarrhea = ETEC HL or HS toxin
Bloody diarrhea + poultry consumption → Campylobacter jejuni or Salmonella spp.
Abx (clindamycin, beta-lactam, cephalosporin) + diarrhea → C. difficile Dx of C. diff → stool AB toxin test, not stool culture
Fever of 104 + abdo distension in C diff → toxic megacolonlaparotomy
Tx of C. diff → vancomycin, not metronidazole (updated guidelines as of Feb 2018)
Bloody diarrhea + travel → Entamoeba histolytica
Tx of E. histolytica → metronidazole + iodoquinol; can give paromomycin
Close quarters or military barracks or cruise ship + watery diarrhea → Norwalk virus
Child <5 years + watery diarrhea → rotavirus
Few organisms causing bloody diarrhea → Shigella
Bloody diarrhea + appendicitis-like pain (pseudoappendicitis) in a child → Yersinia enterocolitica
Bloody diarrhea + reactive arthritis in an adult → Y. enterocolitica, Campylobacter, Shigella, Salmonella
Diarrhea + Guillain-Barre syndrome → Campylobacter
GBSyndrome CSF? →
GBSyndrome Dx? → electromyography + nerve conduction studies (on NBME)
Cardiac ischemia + need to evaluate → ECG stress test first-line
Cardiac ischemia + abnormal baseline ECG (e.g., BBB) → Echo stress test (need normal ECG to do ECG stress test)
Cardiac ischemia + patient can’t exercise → dobutamine + ECG/echo
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