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Discussion Starter · #1 ·
55 y/o man with 2months history of intermittent, severe, sharp, abdominal pain that occurs primarily after meals and last about 30 to 60 minutes. There is no fever, diarrhea, or weight loss. Physical examination shows no abnormalities. Which of the following is the most likely responsible for these symptoms?

A) Acute cholecystitis
B) Ascending cholangitis
C) Biliary colic
D) Primary biliary cirrhosis
E) Sclerosing cholangitis

Which is the answer and why?:confused:
 

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It's possible that she has, PBC, it is a very remote possibility though, because the age is not typical, they didn't say anything about jaundice or itching, you can't possibly say it is PBC just because she has a biliary colick. Remember that in the USMLE sometimes 2 or more answers can be correct, you just have to choose the most commonly encountered answer even if the question doesn't say "most common". Fever and weight loss are very common in those 2 diseases, what I meant to say is there's nothing in the question that is odd for simple gall stones.
 
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