A 75-Year-Old Hospitalized Man Is Evaluated for Abdominal Pain and Fever

question 607

Multiple Choice

A 75-year-old hospitalized man is evaluated for abdominal pain and fever.  The patient was admitted 2 weeks ago due to necrotizing fasciitis of the gluteal region and severe sepsis.  He has been treated with surgical debridements, intravenous antibiotics, and fluids.  For the past 2 days, the patient has had right upper quadrant abdominal pain, nausea, and recurrent fever.  He has a history of hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease.  His temperature is 38.8 C (102 F) .  Physical examination shows marked tenderness over the right subcostal area.  Leukocyte count is 18,000/mm³ compared to 9,600/mm³ 2 days ago.  Laparoscopic surgery is planned.  Which of the following will most likely be found during this patient's surgery?

• A)Choledochal cyst
• B)Fibrotic and shrunken gallbladder
• C)Fluke infection of the biliary tree
• D)Inflamed and enlarged gallbladder
• E)Pigment gallstones
• F)Porcelain gallbladder

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Definitions:

Global Structures

refers to the large-scale patterns and systems that affect individuals and societies worldwide, including economic, political, and cultural dimensions.

Mesostructures

Intermediate-scale structures or frameworks that exist between the macro and micro levels, such as community organizations or networks.

Microstructures

The small-scale, intricate social, physical, or biological arrangements and patterns that make up a larger system or society.

Sociological Imagination

The ability to see the relationship between individual experiences and larger social influences.