SOLVED I-HUMAN CASE STUDY: 18-MONTH-
OLD TODDLER WITH VOMITING AND
DIARRHEA – DIAGNOSIS, DIFFERENTIAL,
SOAP NOTE & CARE PLAN
Why is obtaining a thorough history critical in patients presenting with vomiting and diarrhea? -
answer-History helps narrow differentials and guide diagnostics and treatment decisions
What aspects of history are most important in vomiting and diarrhea cases? - answer-Onset,
duration, progression, appetite changes, exposure risks (toxins, diet, travel), medications, and
vaccination status
Why should clinicians use follow-up questions when obtaining a history? - answer-To clarify
vague information and identify underlying causes
What clinical signs are commonly associated with gastrointestinal disease? - answer-Vomiting,
diarrhea, hyporexia, and lethargy
What is the purpose of creating a prioritized problem list? - answer-To focus diagnostic and
treatment plans on the most clinically relevant issues
What framework can be used to build a differential diagnosis list for vomiting and diarrhea? -
answer-VITAMIN D (vascular, inflammatory/infectious, traumatic/toxic, anatomic, metabolic,
idiopathic, neoplastic, degenerative)
What are the most common categories of disease causing vomiting and diarrhea? - answer-
1
, Inflammatory/infectious, dietary indiscretion, parasitic, toxic, and metabolic causes
What infectious causes should be considered in vomiting and diarrhea cases? - answer-
Bacterial, viral, and parasitic/protozoal pathogens
What bacterial pathogens are associated with gastrointestinal disease? - answer-Clostridium,
Campylobacter, Salmonella, E. coli, Lawsonia
What viral pathogens should be considered in vomiting and diarrhea? - answer-Parvovirus and
coronavirus
What parasitic causes should be considered in vomiting and diarrhea? - answer-Hookworms,
roundworms, whipworms, Giardia, and coccidia
What non-infectious inflammatory causes should be considered in vomiting and diarrhea? -
answer-Dietary indiscretion, stress colitis, pancreatitis, foreign body, and food sensitivity
Why should toxin exposure always be considered in vomiting and diarrhea cases? - answer-
Toxins can cause acute gastrointestinal signs and may require urgent intervention
What are examples of toxins that can cause gastrointestinal disease? - answer-Chocolate,
mycotoxins, cycads, and certain plants such as sabal palm
Why is neoplasia less likely in younger patients with vomiting and diarrhea? - answer-Neoplastic
disease is more common in older animals
Why must clinicians consider metabolic causes of vomiting and diarrhea? - answer-Systemic
diseases such as Addison's disease or exocrine pancreatic insufficiency can present with GI signs
2
OLD TODDLER WITH VOMITING AND
DIARRHEA – DIAGNOSIS, DIFFERENTIAL,
SOAP NOTE & CARE PLAN
Why is obtaining a thorough history critical in patients presenting with vomiting and diarrhea? -
answer-History helps narrow differentials and guide diagnostics and treatment decisions
What aspects of history are most important in vomiting and diarrhea cases? - answer-Onset,
duration, progression, appetite changes, exposure risks (toxins, diet, travel), medications, and
vaccination status
Why should clinicians use follow-up questions when obtaining a history? - answer-To clarify
vague information and identify underlying causes
What clinical signs are commonly associated with gastrointestinal disease? - answer-Vomiting,
diarrhea, hyporexia, and lethargy
What is the purpose of creating a prioritized problem list? - answer-To focus diagnostic and
treatment plans on the most clinically relevant issues
What framework can be used to build a differential diagnosis list for vomiting and diarrhea? -
answer-VITAMIN D (vascular, inflammatory/infectious, traumatic/toxic, anatomic, metabolic,
idiopathic, neoplastic, degenerative)
What are the most common categories of disease causing vomiting and diarrhea? - answer-
1
, Inflammatory/infectious, dietary indiscretion, parasitic, toxic, and metabolic causes
What infectious causes should be considered in vomiting and diarrhea cases? - answer-
Bacterial, viral, and parasitic/protozoal pathogens
What bacterial pathogens are associated with gastrointestinal disease? - answer-Clostridium,
Campylobacter, Salmonella, E. coli, Lawsonia
What viral pathogens should be considered in vomiting and diarrhea? - answer-Parvovirus and
coronavirus
What parasitic causes should be considered in vomiting and diarrhea? - answer-Hookworms,
roundworms, whipworms, Giardia, and coccidia
What non-infectious inflammatory causes should be considered in vomiting and diarrhea? -
answer-Dietary indiscretion, stress colitis, pancreatitis, foreign body, and food sensitivity
Why should toxin exposure always be considered in vomiting and diarrhea cases? - answer-
Toxins can cause acute gastrointestinal signs and may require urgent intervention
What are examples of toxins that can cause gastrointestinal disease? - answer-Chocolate,
mycotoxins, cycads, and certain plants such as sabal palm
Why is neoplasia less likely in younger patients with vomiting and diarrhea? - answer-Neoplastic
disease is more common in older animals
Why must clinicians consider metabolic causes of vomiting and diarrhea? - answer-Systemic
diseases such as Addison's disease or exocrine pancreatic insufficiency can present with GI signs
2
