USMLE Forum Archives - USMLE Step 3 - IM12
IM12
bingousmle - 06-20-10 06:11
A woman presents to the ED complaining of pain in her RUQ that is steady but gets worse with eating over the past 2 days. The pain also radiates to the right side of her midback. She denies vomiting. Her only medication is an oral contraceptive. Her BP is 140/75 mm Hg, HR is 80 beats per minute, temperature is 98.7°F, and RR is 16 breaths per minute. Laboratory tests are within normal limits. An abdominal ultrasound reveals stones in her gallbladder, but no thickened wall or pericholecystic fluid. What is the most likely diagnosis?
a. Cholangitis
b. Urolithiasis
c. Cholecystitis
d. Biliary colic
e. Peptic ulcer disease
bingousmle - 06-20-10 06:11
A woman presents to the ED complaining of pain in her RUQ that is steady but gets worse with eating over the past 2 days. The pain also radiates to the right side of her midback. She denies vomiting. Her only medication is an oral contraceptive. Her BP is 140/75 mm Hg, HR is 80 beats per minute, temperature is 98.7°F, and RR is 16 breaths per minute. Laboratory tests are within normal limits. An abdominal ultrasound reveals stones in her gallbladder, but no thickened wall or pericholecystic fluid. What is the most likely diagnosis?
a. Cholangitis
b. Urolithiasis
c. Cholecystitis
d. Biliary colic
e. Peptic ulcer disease
The correct answer and explanation will be available after you answer.
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#2
Re: IM12 babbu5508 - 06-20-10 14:13 My answer is: d.
pain in her RUQ that is steady but gets worse with eating...biliary colic..the presence of gallstones is a frequent incidental finding and does not always necessitate treatment, in the absence of identifiable disease
#5
Re: IM12
bingousmle - 06-30-10 18:57 My answer is: d.
as there is no evidence of inflammation of gall bladder on ultrasound cholecystitis is ruled out.. murphys triad is not there so not cholangitis either
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