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myoclonictonicbionic
How would stool be different in secretory or osmotic diarrhea? They state that he has loose stool which could also indicate osmotic/secretory diarrhea. I think they are trying to hint that he has diabetes for 26yrs therefore he has diabetes enteropathy and therefore motility issues
+6
takayasuarteritis
I'm with you on this. I think it's a myenteric nerve plexus issue from long-standing diabetes.
+14
drpee
Neuropathy makes sense for T1DM, I guess I just expected a motility issue to cause constipation rather than diarrhea...
+19
mnunez187
Moving too fast or moving too slow
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an1
@drpee yeah same, UW mentioned that damage to enteric nerves in DM leads to constipation, so I thought the motility disorder should have constipation
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takayasuarteritis
Why does his cell differential show no eosinophilia? Schistosoma is a worm..?
+2
takayasuarteritis
It also says in FA that SCC of bladder is associated with painless hematuria. My dude in the question stem is having "pain with urination that has increased in severity during the past month."
+5
melchior
@Takayasuarteritis, technically he does have eosinophilia. Reference range is 1 - 3%. His is 5%. Also, although SCC of bladder presents with painless hematuria, schistosomiasis itself can have hematuria, and that hematuria can be painful.
+2
bekindstep1
FA (2019 pg 160) does say it would be painless specifically which is what made me lean against schistosomiasis
+1
itsalwayslupus
I think the calcifications, immigration from Africa, eosinophilia, chronic inflammation, and granuloma formation (which can occur with a schistomiasis infection) all together (+ a very slight fever) would all lead to Schistosomiasis, and you would just have to ignore that urination is painful, because many other factors could be causing that too outside of the traditional acute schistosomiasis infection. The pain here is just not the most important factor I don't think.
+11
takayasuarteritis
Why does his cell differential show no eosinophilia? Schistosoma is a worm..?
+2
takayasuarteritis
It also says in FA that SCC of bladder is associated with painless hematuria. My dude in the question stem is having "pain with urination that has increased in severity during the past month."
+5
melchior
@Takayasuarteritis, technically he does have eosinophilia. Reference range is 1 - 3%. His is 5%. Also, although SCC of bladder presents with painless hematuria, schistosomiasis itself can have hematuria, and that hematuria can be painful.
+2
bekindstep1
FA (2019 pg 160) does say it would be painless specifically which is what made me lean against schistosomiasis
+1
itsalwayslupus
I think the calcifications, immigration from Africa, eosinophilia, chronic inflammation, and granuloma formation (which can occur with a schistomiasis infection) all together (+ a very slight fever) would all lead to Schistosomiasis, and you would just have to ignore that urination is painful, because many other factors could be causing that too outside of the traditional acute schistosomiasis infection. The pain here is just not the most important factor I don't think.
+11
This question is really testing what the different types of diarrhea show. Key is "stool shows no abnormalities". In malabsorption, exudative, osmotic, and secretory diarrhea, your poop would be weird in some way. A motility disorder is the ONLY type here that would cause normal poop.