QBDOTW: An obese 49-year-old, G3, P3 woman

MedSmarter: Question Break Down of the Week - Reproductive - Obese 49 Year Old Female

QBDOTW: A Obese 49-year-old, G3, P3 Female Patient

Welcome to MedSmarter’s USMLE Style Question Break Down of the Week.  For those preparing for the USMLE Step 1, this week we break down a high-yield Gastrointestinal question.  As always you want to begin with reading the last sentence of the vignette first to get an understanding of what the question is asking for.

Question Break Down of the Week:

An obese 49-year-old, G3, P3 woman presents to the physician with right upper quadrant pain and fever that was preceded by nausea and vomiting. Ultrasonography shows hyperechogenic structures in the right upper quadrant. Laboratory testing reveals a WBC count of 15,000/mm3, an erythrocyte sedimentation rate of 45 mm/hr., and a serum amylase level of 75 U/L. Which of the following is the most likely diagnosis in this patient?

A)  Acute pancreatitis
B)  Acute calculous cholecystitis
C)  Carcinoma of the pancreas
D)  Cholesterolosis
E)  Acute acalculous cholecystitis

The correct answer choice is B: Right upper quadrant pain in an obese, middle-aged, multiparous woman with ultrasonographic findings consistent with gallstones is a classic presentation of acute calculous cholecystitis. Acute calculous cholecystitis is an acute mechanical inflammation of the gallbladder commonly resulting from a gallbladder stone obstructing the gallbladder neck or cystic duct. Treatment if symptomatic is surgical removal. Risk factors are the “4F’s”: Female, “Fat,” Fertile, and Forty. Definitive treatment is cholecystectomy.

Did you think the answer was different?

Did you think that the correct answer choice was other than B?  You can view this video for a deeper discussion of why A, C, D, and E were not the correct answer choices.

Learn to correctly answer basic science knowledge questions and prepare to take your USMLE Step 1 exam.  The MedSmarter roadmap will make your journey to becoming a practicing physician in the United States as painless as possible.

More Free Content:

There are additional videos covering topics from Cardiology, Biostatistics, Endocrinology, Genetics, Neurology, Hematology, and more.  Be sure to subscribe to the MedSmarter Youtube channel so you don’t miss out.  The Question Break Down of the Week videos are posted every Wednesday and new content videos are posted every Tuesday and Thursday.
Our Popular Courses

Prepare to Ace Your USMLE Step 1

A Continuous Enrollment Cycle allows students more flexibility for your USMLE Step 1 Prep.

Prepare to ACE Your USMLE Step 2 CK

A Continuous Enrollment Cycle allows students more flexibility when preparing for your Step 2 CK Exam.

1:1 Personalized Tutoring Sessions

Begin with an initial consultation with a tutor to assess your strengths, weaknesses, and identify goals.

Latest Articles From Medsmarter
The Hospital Medical Hierarchy - medsmarter

The Hospital Medical Hierarchy Every Pre-Med Should Understand

Doctors medical team

How Can Foreign Medical Graduates and Doctors Practice in the US?

Skills Are Needed To Be A Doctor - medsmarter

What Skills Are Needed To Be A Doctor?

What Is the USMLE Step 1?

What Is the USMLE Step 1? Purpose, Benefits & Resources

how to become a doctor - medsmarter

7 Steps to Become a Doctor After High School

STAY CONNECTED: Signup for Email Updates

Recent Tweets

Put yourself in MedSmarter's capable hands and never look back! I struggled with Step 1 prep for 2 years before discovering MedSmarter. Dr. Untara's dedication and investment in each student is... read more

Natasha Singh Avatar Natasha Singh

Join the 1,000s of Students Benefitting from the MedSmarter Approach Now

Share This Story, Choose Your Platform!