A 44-Year-Old Man Who Has Had an Extensive Small Bowel

question 459

Multiple Choice

A 44-year-old man who has had an extensive small bowel resection for Crohn disease has been on total parenteral nutrition for two years.  He presented to the hospital with epigastric and right upper quadrant pain.  His vital signs are within normal limits.  Physical examination shows mild right upper quadrant tenderness.  An ultrasonogram shows several gallstones; an ultrasonogram performed two years ago did not demonstrate gall stones.  Which of the following is the most likely cause of his gallstones?

• A)Estrogen-induced increase in cholesterol secretion
• B)Gallbladder stasis
• C)Hypertriglyceridemia
• D)Increased enterohepatic recycling of bile acids
• E)Increased red blood cell destruction

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Definitions:

Diversification

A risk management strategy that involves allocating investments among various financial instruments, industries, or other categories to minimize risk.

Expected Value

A calculated average of all possible values for a random variable, weighted by their probabilities of occurrence.

Health Costs

Expenses associated with maintaining, improving, or treating an individual’s health, including medical care, medication, and hospitalization.

Moral Hazard

Moral hazard occurs when one party in an agreement can take risks because the negative consequences of their actions will be borne by another party.