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:

Prime Rate

The interest rate that commercial banks charge their most credit-worthy customers, frequently used as a benchmark in lending rates.

Commercial Banks

Financial institutions that accept deposits, offer various loans, and provide other financial services to the public.

Open Market Operations

Central bank activities involving the buying or selling of government securities to control the money supply and interest rates.

Discount Rate

The interest rate set by central banks that is charged to commercial banks for loans, influencing monetary policy and the money supply.