WBR0657

Author	[[PageAuthor::Anonymous (Reviewed by Alison Leibowitz)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathophysiology
Sub Category	SubCategory::Gastrointestinal
Prompt	[[Prompt::An obese, multiparous, 48-year-old female presents to the physician's office with a nonradiating right upper quadrant abdominal pain with bloating, nausea, and vomiting that worsens after the consumption of fries and a hamburger. Abdominal ultrasonography displays hyperechogenic foci within the thickened gallbladder wall. Laboratory testing reveals a WBC count of 16,000/μL and serum amylase and lipase levels of 75 U/L and 150 U/L, respectively. Which of the following secreted substances most likely accounts for her abdominal pain?]]
Answer A	AnswerA::Cholecystokinin
Answer A Explanation	AnswerAExp::See overall explanation
Answer B	AnswerB::Gastrin
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::Pepsin
Answer C Explanation	AnswerCExp::
Answer D	AnswerD::Secretin
Answer D Explanation	AnswerDExp::
Answer E	AnswerE::Gastric inhibitory peptide
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::A
Explanation	[[Explanation::The patient in this scenario demonstrates classic findings of acute calculous cholecystitis. Acute calculous cholecystitis typically develops in patients who fit the profile of the 4F's: Female, Fat, Fertile, and in her Forties. Strenuous contraction of the gallbladder, described as a nonradiating abdominal pain in the right upper quadrant, is secondary to the effect of cholecystokinin, which is secreted in response to ingestion of lipids and proteins. Educational Objective: Acute calculous cholecystitis typically develops in patients who fit the profile of the 4F's (Female, Fat, Fertile, and in her Forties). It is often manifested as a nonradiating right upper quadrant pain due to strenuous contraction of the gallbladder induced by cholecystokinin. References: Le T, Bhushan V. First Aid for the USMLE Step 1 2014. McGraw-Hill Medical; 2014.]]
Approved	Approved::No
Keyword	WBRKeyword::Cholelithiasis, WBRKeyword::Cholecystitis, WBRKeyword::Cholecystokinin
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::