Gallstones Fitz

Question 1

29. A 43-year-old woman has a 12-hour history of sudden onset of right upper quadrant abdominal pain with
    radiation to the shoulder, fever, and chills. She has had similar, milder episodes in the past. Examination reveals marked tenderness to right upper quadrant
    abdominal palpation. Her most likely diagnosis is:
    A. hepatoma.
    B. acute cholecystitis.
    C. acute hepatitis.
    D. cholelithiasis.

Answer 1

B. acute cholecystitis.

Question 2

30. Which of the following is usually not seen in the diagnosis of acute cholecystitis?
    A. elevated serum creatinine
    B. increased alkaline phosphatase level
    C. leukocytosis
    D. elevated aspartate aminotransferase (AST) level

Answer 2

A. elevated serum creatinine

Question 3

31. Murphy’s sign can be best described as abdominal pain elicited by:

A. right upper quadrant abdominal palpation.
B. asking the patient to stand on tiptoes and then letting body weight fall quickly onto the heels.
C. asking the patient to cough.
D. percussion.

Answer 3

A. right upper quadrant abdominal palpation.

Question 4

32. Which of the following is the most common serious complication of cholecystitis?
A. adenocarcinoma of the gallbladder
B. gallbladder empyema
C. hepatic failure
D. pancreatitis

Answer 4

D. pancreatitis

Question 5

33. A 58-year-old man reports intermittent right upper quadrant abdominal pain. He is obese and being actively treated for hyperlipidemia. Imaging in a
    patient with suspected symptomatic cholelithiasis usually includes obtaining an abdominal:
    A. MRI.
    B. CT scan.
    C. ultrasound of the right upper quadrant.
    D. flat plate.

Answer 5

C. ultrasound of the right upper quadrant.

Question 6

34. Which of the following is most likely to be found in a person with acute cholecystitis?
A. fever
B. vomiting
C. jaundice
D. palpable gallbladder

Answer 6

B. vomiting

Question 7

35. Risk factors for the development of cholelithiasis include all of the following except:
A. rapid weight loss.
B. male gender.
C. obesity.
D. Native American ancestry

Answer 7

B. male gender.

Question 8

36. A gallstone that is not visualized on standard x-ray is said to be:
A. radiopaque.
B. radiolucent.
C. calcified.
D. unclassified

Answer 8

B. radiolucent.