Mock 11

Patient Prompts

• Mr. Brooks reports, "I’ve had loose stools several times a day since starting the antibiotics, and I’m worried it’s caused by the medication."
• Expresses frustration: "I think the treatment wasn’t right; the antibiotics are making me sick."

Scenario Clinchers

• The patient appears anxious and is seeking reassurance about his treatment.
• Concerned about the ongoing diarrhea and its impact on his daily activities.

Patient Concerns

• Anxious about the diarrhea being a result of the antibiotic treatment.
• Worried that the initial dog bite wound treatment was incorrect or inadequate.

Clinchers and Important Points for the Doctors

• Consider antibiotic-associated diarrhea, a common side effect, particularly if broad-spectrum antibiotics were used.
• Rule out other causes of diarrhea, including Clostridioides difficile infection, especially if the patient presents with severe abdominal pain, fever, or bloody stools.

What Is Expected from the Doctor

• Validate the patient’s concerns and empathize with his discomfort.
• Conduct a thorough assessment, including reviewing the wound site, checking for signs of infection or complications, and evaluating the diarrhea's characteristics.
• Discuss the balance between the benefits of antibiotic therapy for the dog bite and the potential side effects, including diarrhea.

Red Flags

• Signs of severe dehydration (e.g., dry mucous membranes, tachycardia, hypotension).
• Symptoms suggesting a more serious condition, like Clostridioides difficile infection (severe abdominal pain, high fever, bloody diarrhea).

Actions Doctor Should Do

• Reassess the wound for signs of infection or complications.
• Manage the diarrhea symptomatically and consider stool testing if symptoms are severe or persistent.
• Educate the patient on the importance of completing the antibiotic course (if still indicated) and discuss ways to manage side effects.

Referral Needs

• Consider referral to a gastroenterologist if there is suspicion of a severe gastrointestinal condition or if symptoms do not resolve.
• Follow-up with or refer back to a healthcare professional skilled in wound care if there are concerns about the wound healing or infection.

Reason for Referral

• Ensure comprehensive evaluation and management if there are signs of a more serious gastrointestinal issue or if the diarrhea persists despite conservative management.
• To reassess and manage the dog bite wound, ensuring it is healing appropriately and there are no signs of infection or other complications.