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A 43-Year-Old Woman Comes to the Office Due to 2

Question 502
Multiple Choice
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Multiple Choice

A 43-year-old woman comes to the office due to 2 days of frequent "runny stools."  She has not noticed blood or mucus in her stool but has had nausea, abdominal cramping, and malaise.  Yesterday, the patient returned from a week-long vacation in Honduras, where she saw notable sights, snorkeled in the Caribbean Sea, and ate food from street vendors.  Her medical history is significant for obesity, hypercholesterolemia, and gastroesophageal reflux disease.  The patient takes atorvastatin and omeprazole and has not recently used antibiotics.  She does not smoke tobacco or drink alcohol.  Temperature is 37.8 C (100 F), blood pressure is 130/80 mm Hg, pulse is 80/min, and respirations are 12/min.  BMI is 31 kg/m2.  The patient appears uncomfortable.  The abdomen is soft and mildly tender but no guarding, rigidity, or rebound tenderness is present.  The remainder of the physical examination is normal.  Laboratory results are as follows: img Which of the following pathogens is the most likely cause of this patient's symptoms?

A)Escherichia coli
B)Giardia lamblia
D)Shigella dysenteriae
E)Vibrio parahaemolyticus

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