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A 25-Year-Old Man Comes to the Emergency Department Due to Abdominal

question 415

Multiple Choice

A 25-year-old man comes to the emergency department due to abdominal pain, nausea, and vomiting. The symptoms began 2 months ago, at which time the pain was intermittent and located in the right lower quadrant. Since then, it has progressed and is now diffuse, severe, and unremitting. The patient started vomiting bilious fluid 2 days ago but has not had hematemesis, melena, hematochezia, diarrhea, or unexpected weight loss. In addition, he has not moved his bowels in 2 days, although he frequently passes flatus. Medical history is significant for Crohn disease with ileal involvement, which is currently managed with infliximab and has never required surgery. The patient has used acetaminophen and ibuprofen to relieve his pain and has not used narcotics. He smokes 3-4 cigarettes a day but does not use alcohol or illicit drugs. Temperature is 37.5 C (99.5 F) , blood pressure is 134/78, pulse is 95/min, and respirations are 18/min. On physical examination, the patient is awake and cooperative. Chest examination is unremarkable. The abdomen is distended, tympanic, and tender to palpation; there is no rebound tenderness or guarding. Which of the following most likely explains this patient's presentation?

Definitions:

Overtime

Additional hours worked beyond the standard work schedule, usually compensated at a higher rate.

Subcontracting

The practice of assigning specific tasks, projects, or production processes to external firms to leverage specialized capabilities or manage capacity.

Plant Capacity

The maximum volume of products that a manufacturing plant can produce over a specific period, reflecting the facility's size and efficiency.

Vital Capacity

The maximum amount of air a person can expel from the lungs after a maximum inhalation, used to assess the health of respiratory systems.