WBR0657

Author	[[PageAuthor::Gerald (Reviewed by Alison Leibowitz)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathophysiology
Sub Category	SubCategory::Gastrointestinal
Prompt	Prompt::
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 symptoms, as well as laboratory and imaging results, which are suggestive of gallstone cholecystitis. Gallstone cholecystitis is typically presented in patients who fit the profile of the “4F’s”: Female, Fat, Fertile, and Forty. The right upper-quadrant pain that results from gallbladder contraction, is induced by cholecystokinin (CCK), which secretes in response to the presence of peptides, amino acids, and fatty acids in the duodenum. ADD TABLE gallbladder contraction, which produces right upper quadrant pain in an obese, middle-aged, multiparous women 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, chemical inflammation, and/or bacterial inflammation. Educational Objective: Gallstone cholecystitis, induced by cholecystokinin, is typically presented in patients who fit the profile of the “4F’s”: Female, Fat, Fertile, and Forty. References: Le T, Bhushan V. First Aid for the USMLE Step 1 2014. McGraw-Hill Medical; 2014.]]
Approved	Approved::No
Keyword	WBRKeyword::Gallstone ileus, WBRKeyword::Cholelithiasis, WBRKeyword::Cholecystitis
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::