A 45-year-old woman, with aa history of gallstones for the past 2 years, has recurrent episodes of biliary colic that require short ER treatment with analgesics and antispasmoic. This time she develops a similar type pain but of a much severe intensity associated with fever and nausea. She appears exhausted and tired, temp 36.6 C, right hypochondrial tenderness with a positive murphy’s sign. Lab work shows a WBC 20, Neu 88%, AST and ALT are normal, total bilirubin is normal. Which of the following is the most likely diagnosis?
سؤال مجاني 10 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Acute cholecystitis
A known gallstone patient now has more severe, prolonged pain with a positive Murphy sign and marked leukocytosis (WBC 20, 88% neutrophils), which is acute cholecystitis. Normal bilirubin and transaminases argue against cholangitis, because cholestasis is uncommon in cholecystitis and suggests duct obstruction. Simple biliary colic would not cause leukocytosis and a positive Murphy sign. (The listed temperature of 36.6 C conflicts with "fever" but does not change the answer.)
- المصدر
- Gallbladder Conditions -.pdf · p. 3
- المحاضرة
- Gallbladder Conditions · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 74 Q23