ROSH Gastrointestinal Practice Exam

What management is indicated for a 17-year-old boy with abdominal cramping and diarrhea after eating at a picnic?

1. Anitiemetics and fluids

2. Ciprofloxacin

3. CT scan of the abdomen and pelvis

4. Stool cultures

The correct answer is: Anitiemetics and fluids

In the context of a 17-year-old boy experiencing abdominal cramping and diarrhea after eating at a picnic, the appropriate management involves addressing the symptoms and providing supportive care, which includes antiemetics and fluids. This approach is particularly relevant in cases of acute gastroenteritis, which is often caused by foodborne pathogens commonly encountered in picnic settings, such as viruses or bacteria. Antiemetics are useful for managing nausea and vomiting that may accompany diarrhea, improving the patient's comfort. Additionally, rehydrating with fluids is critical, as diarrhea can lead to dehydration, especially in younger individuals. Fluid replacement helps restore electrolyte balance and prevents complications associated with dehydration. While stool cultures can be important in diagnosing specific pathogens if the symptoms persist or worsen, they are not routinely performed immediately unless there are concerning features (such as high fever, blood in the stool, or severe dehydration). Similarly, while antibiotics like Ciprofloxacin may be warranted in more severe cases of bacterial infections, they are not indicated in most cases of mild acute gastroenteritis, especially if caused by viruses. A CT scan is usually unnecessary in this scenario, as the patient's symptoms are likely management-focused and based on less severe gastrointestinal complaints. Thus, the management choice of providing antiemetics and fluids