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

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Definitions:

American Currency

The system of money in use in the United States, primarily consisting of the United States Dollar (USD).

Ethnocentrism

The belief in the inherent superiority of one's own ethnic group or culture, often accompanied by a feeling of contempt for other cultures.

Stereotyping

The act of generalizing characteristics, attributes, or behaviors to all members of a particular group, disregarding individual differences.

Cultural Norm

Shared expectations and rules that guide behavior of people within social groups.