A 27-Year-Old Woman Is Brought to the Emergency Department with Severe

question 285

Multiple Choice

A 27-year-old woman is brought to the emergency department with severe epigastric pain, nausea, and vomiting.  The pain radiates to her back and is exacerbated by eating.  The patient was recently diagnosed with functional biliary sphincter of Oddi dysfunction for which she underwent an endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy 24 hours ago.  She has no other chronic medical conditions.  She does not drink alcohol.  Temperature is 38.7 C (101.7 F) , blood pressure is 124/82 mm Hg, pulse is 95/min, and respirations are 19/min.  There is no scleral icterus.  Cardiopulmonary examination shows no abnormalities.  The abdomen is tender to palpation in the epigastrium, soft, and without rebound or guarding.  Which of the following is the most appropriate next step in management of this patient?

• A)CT scan of the abdomen
• B)HIDA scan
• C)MR cholangiopancreatography
• D)Right upper quadrant ultrasound
• E)Serum lipase

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Definitions:

Bodily Contact

Physical interaction involving direct touch between individuals, which can be a mode of transmission for certain diseases.

Permission

The authorization to do something that is granted by a figure of authority.

Intentional Tort

A type of civil wrong where the perpetrator deliberately inflicts harm or injury on another individual, leading to legal liability.

Guaranteed Cures

Promises or assurances of completely resolving a medical condition or disease, often viewed with skepticism due to the complexity of human health.