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Questions 1 and 2 refer to the following case study.
A 40-year-old woman has had right upper quadrant abdominal pain, fever, and nausea for the past 2 days. She reports no history of alcohol use.
1. What is the most likely etiology of this patients abdominal pain?
- Appendicitis
- Cholecystitis
- Pancreatitis
- Peptic ulcer disease
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2. Which of the following signs would be most helpful in confirming the suspected diagnosis?
- Cullens sign
- Murphys sign
- Obturator sign
- Psoas sign
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Questions 3 and 4 refer to the following case study.
A 30-year-old man reports suddenly awakening from sleep with severe upper abdominal pain. The pain was originally located in the epigastric region, but now the abdomen is diffusely tender.
3. What is the most likely diagnosis?
- Cholangitis
- Pancreatitis
- Perforated appendix
- Perforated peptic ulcer
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4. Which of the following is the most appropriate test to order at this time?
- Abdominal ultrasonography
- Supine abdominal radiograph
- Upper gastrointestinal series
- Upright chest radiograph
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5. A 30-year-old man reports a 6-hour history of abdominal pain that originally began in the periumbilical region but has since migrated the to the left lower quadrant. The patient experiences a worsening of the pain when his right hip is extended while he is in the left lateral decubitus position. What is the most likely diagnosis?
- Appendicitis
- Cholecystitis
- Ureteral lithiasis
- Urinary tract infection
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