ROSH Gastrointestinal Practice Exam

A 43-year-old woman with right upper quadrant pain is most likely diagnosed with which condition?

1. Acute cholecystitis

2. Acute pancreatitis

3. Appendicitis

4. Peptic ulcer disease

The correct answer is: Acute cholecystitis

The condition most likely diagnosed in a 43-year-old woman presenting with right upper quadrant pain is acute cholecystitis. This condition is characterized by inflammation of the gallbladder, often due to the obstruction of the cystic duct by gallstones. The pain typically localizes in the right upper quadrant and may be accompanied by other symptoms such as nausea, vomiting, and possibly fever. Acute cholecystitis often presents with the classic Murphy’s sign during physical examination, which is a sharp pain upon palpation of the right upper quadrant due to the inflamed gallbladder. Additionally, this condition is more common in females and can occur after episodes of biliary colic. Other conditions related to abdominal pain may present similarly, but they have different underlying causes and factors that distinguish them from acute cholecystitis. Acute pancreatitis typically presents with epigastric pain that may radiate to the back, often associated with history of alcohol use or gallstones but typically does not localize specifically to the right upper quadrant. Appendicitis usually presents with pain that begins around the umbilicus and then migrates to the right lower quadrant. Peptic ulcer disease is characterized by epigastric pain that may have