ROSH Gastrointestinal Practice Exam

Which demographic is at the highest risk for developing cholelithiasis?

1. 35-year-old thin man with gastric ulcers

2. 21-year-old woman of European descent

3. 55-year-old man on a statin medication

4. 41-year-old obese, pregnant woman

The correct answer is: 41-year-old obese, pregnant woman

The demographic most at risk for developing cholelithiasis, or gallstones, includes individuals who are obese and pregnant. In this case, the woman is both obese and pregnant, which places her in a high-risk category due to several factors. Pregnancy increases the levels of estrogen, which can promote the formation of gallstones. Additionally, obesity is a well-known risk factor for gallstone development, as it often leads to increased cholesterol saturation in bile and decreased gallbladder motility. This combination of factors can significantly elevate the likelihood of gallstone formation. While the other options include various factors that can relate to gallstone risk, they do not combine the significant factors seen in the correct demographic. For example, while gastric ulcers or young age might involve individuals who have gallstones, they do not convey the same level of risk as the combination of obesity and pregnancy.