A 62-Year-Old Man Comes to the Emergency Department Due to Severe

question 103

Multiple Choice

A 62-year-old man comes to the emergency department due to severe colicky upper abdominal pain, nausea, and vomiting.  He reports several episodes of similar abdominal discomfort in the past.  The patient does not use tobacco, alcohol, or illicit drugs.  He immigrated to the United States from East Asia several years ago.  Physical examination shows right upper quadrant abdominal tenderness.  An imaging study shows several gallstones in the common bile duct and gallbladder.  The stones are removed from the duct endoscopically, and a cholecystectomy is also performed.  The gallstones are dark brown, soft, and composed primarily of calcium bilirubinate with variable amounts of cholesterol.  Which of the following enzymes most likely played an important role in the pathogenesis of this patient's condition?

• A)7-alpha-hydroxylase
• B)Aromatase
• C)Beta-glucuronidase
• D)Desmolase
• E)HMG-CoA reductase

---

Definitions:

Bar Chart

A visual representation of data using bars of different heights or lengths to compare values across categories.

Interval Scale

A scale of measurement where the intervals between values are uniform but there is no true zero point, allowing for the measurement of order and the calculation of meaningful differences between values.

Nominal Scale

A measurement scale used for categorizing variables without a quantitative value or order.

Pie Graph

A visual representation of data that divides a circle into slices to illustrate numerical proportions.