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Q1: Answer: A
Rationale
Vibrio cholerae is a cause of secretory diarrhea. Fecal osmotic gap calculation can be useful in the evaluation of a patient with chronic diarrhea to differentiate between osmotic and secretory diarrhea. It is calculated by subtracting measured fecal electrolytes from normal lumen osmolality (290 – 2(fecal Na+ fecal K)). Secretory diarrhea is characterized by a fecal osmotic gap of less than 50 mOsm/kg, therefore answer A is the correct answer. Osmotic diarrhea is characterized by a fecal osmotic gap greater than 50 mOsm/kg or more specifically, more than 100 mOsm/kg, therefore answer B is incorrect. Accurate fecal osmotic gap calculation depends on normal stool osmolality, which is 290 mOsm/kg. Hypertonic (answer D) or dilute (answer C) stool samples are not appropriate for the calculation of the fecal osmotic gap, therefore answer C and D are incorrect.
Reference
- Eherer A.J., Fordtran J.S. Fecal osmotic gap and pH in experimental diarrhea of various causes. Gastroenterology. 1992;103:545-51.
Q1: Answer: A
Rationale
Vibrio cholerae is a cause of secretory diarrhea. Fecal osmotic gap calculation can be useful in the evaluation of a patient with chronic diarrhea to differentiate between osmotic and secretory diarrhea. It is calculated by subtracting measured fecal electrolytes from normal lumen osmolality (290 – 2(fecal Na+ fecal K)). Secretory diarrhea is characterized by a fecal osmotic gap of less than 50 mOsm/kg, therefore answer A is the correct answer. Osmotic diarrhea is characterized by a fecal osmotic gap greater than 50 mOsm/kg or more specifically, more than 100 mOsm/kg, therefore answer B is incorrect. Accurate fecal osmotic gap calculation depends on normal stool osmolality, which is 290 mOsm/kg. Hypertonic (answer D) or dilute (answer C) stool samples are not appropriate for the calculation of the fecal osmotic gap, therefore answer C and D are incorrect.
Q1: Answer: A
Rationale
Vibrio cholerae is a cause of secretory diarrhea. Fecal osmotic gap calculation can be useful in the evaluation of a patient with chronic diarrhea to differentiate between osmotic and secretory diarrhea. It is calculated by subtracting measured fecal electrolytes from normal lumen osmolality (290 – 2(fecal Na+ fecal K)). Secretory diarrhea is characterized by a fecal osmotic gap of less than 50 mOsm/kg, therefore answer A is the correct answer. Osmotic diarrhea is characterized by a fecal osmotic gap greater than 50 mOsm/kg or more specifically, more than 100 mOsm/kg, therefore answer B is incorrect. Accurate fecal osmotic gap calculation depends on normal stool osmolality, which is 290 mOsm/kg. Hypertonic (answer D) or dilute (answer C) stool samples are not appropriate for the calculation of the fecal osmotic gap, therefore answer C and D are incorrect.
Reference
- Eherer A.J., Fordtran J.S. Fecal osmotic gap and pH in experimental diarrhea of various causes. Gastroenterology. 1992;103:545-51.
Reference
- Eherer A.J., Fordtran J.S. Fecal osmotic gap and pH in experimental diarrhea of various causes. Gastroenterology. 1992;103:545-51.
A 37-year-old man presents with acute nausea, vomiting, and diarrhea consistent with an acute Vibrio cholerae infection.