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Discussion Starter · #1 ·
A 50 year old man presented to the ER with severe right upper quadrant pain that started few hours ago after feeling unwell for 3 days. On examination his temperature was 39.1, BP 120/75, RR 18, PR 95. Severe tenderness in the right upper quadrant area elicited and an inspiratory catch noted when deep palpation attempted in the same area. Which of the following is adequate management for this patient?
A- Intravenous fluids and observation
B- Intravenous antibiotics and observation
C- Referral to surgical services for next day surgery
D- Immediate surgical referral for urgent surgery
E- Urgent percutanous drainage
 

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A/c abdominal case !!

The answer will lie between A and B.
But I prefer A.
 

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Discussion Starter · #5 ·
Treatment is cholecystectomy

So you think it's a surg emergency?
Could you please explain me in depth?
Thank a lot !
It's not an emergency, it's next day surgery.
This patient is having gall stones causing acute cholecystitis. While fluids, analgesia, antibiotics help, still the mainstay of therapy is cholecystectomy in calcular cholecystitis.
Since there are two similar options, they are both wrong A and B. See what Rasheed wrote here
http://www.usmle-forums.com/usmle-articles/1928-two-similar-options-wrong.html
 

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It's not an emergency, it's next day surgery.
This patient is having gall stones causing acute cholecystitis. While fluids, analgesia, antibiotics help the mainstay of therapy is cholecystectomy in calcular cholecystitis.
Since there are two similar options, they are both wrong A and B. See what Rasheed wrote here
http://www.usmle-forums.com/usmle-articles/1928-two-similar-options-wrong.html
Thanks a lot.
Plz post more to lessen our forum members' mistakes during exam.
Thanks a million, friend 13monument.
 
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