4 board-style questions on constipation in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 70-year-old woman presents with chronic constipation for the past year, reporting fewer than 3 bowel movements per week. She strains frequently and often feels incomplete evacuation. She drinks adequate fluids, eats a high-fiber diet (25 g daily), and walks 30 minutes daily. She takes calcium carbonate for osteoporosis and occasional acetaminophen. She has no alarm symptoms such as rectal bleeding, weight loss, or change in stool caliber. What is the most appropriate first-line pharmacologic therapy?
A 4-year-old girl is brought in for evaluation of infrequent, hard, painful stools occurring every 4-5 days for the past 3 months. She occasionally has streaks of bright red blood on the stool surface. She withholds stool by stiffening her legs and crossing them. Her abdomen is soft with a palpable stool mass in the left lower quadrant. Growth parameters are normal. What is the most appropriate initial treatment?
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