← back to the Substrate Record
qid 6440 · health
Question: A 27-year-old woman comes to the physician because of a 3-year history of chronic diarrhea and intermittent, crampy, lower abdominal pain. The pain is usually relieved with defecation and does not occur at night or interfere with sleep. She says she is frustrated by her symptoms and has stopped traveling because of her frequent, urgent need to use the bathroom. She has no history of serious illness and takes no medications. Her temperature is 37°C (98.6°F), pulse is 70/min, respirations are 14/min, and blood pressure is 120/80 mm Hg. The lower abdomen is mildly tender to palpation; there is no rebound tenderness or guarding. The remainder of the examination shows no abnormalities. Results of laboratory studies are within the reference ranges. Test of the stool for occult blood is negative. Antigliadin antibodies are not present. Which of the following is the most appropriate pharmacotherapy?
- Sertraline
- Nefazodone
- Phenelzine
- Trazodone
- Nortriptyline
- Paroxetine
- Fluoxetine
- Lorazepam
- Venlafaxine
- Zolpidem
Our answer: E. Nortriptyline Source quote machine-checked (strict)
How it was answered
Multi-step solver (maze), replayed by code
Current source
Lacy BE, et al. "ACG Clinical Guideline: Management of Irritable Bowel Syndrome." Am J Gastroenterol. 2021;116(1):17-44.
https://doi.org/10.14309/ajg.0000000000001036
Source quote machine-checked (strict)
Earlier version (superseded)
https://doi.org/10.14309/ajg.0000000000001036
Source weak (http_get_200_text_and_question_terms)
Earlier version (superseded)
No public source has been found for this card yet (3 places checked internally).