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Exam questionKROK 2Medicine · 2025

A 53-year-old woman complains of nausea, vomiting bile, and acute pain in the right hypochondrium. The pain occurred 2 hours after a dinner. According to the patient's history, the symptoms appeared 18 hours ago. Objectively, the patient is agitated and fidgets in the bed, pulse 98/min, the tongue is moist and coated with white deposits. Body temperature 38.2°C. Palpation detects that the right half of the chest lags behind of breathing, muscle tension and tenderness can be observed in the right hypochondrium. Phrenicus symptom and Grekov-Ortner sign are positive. Signs of peritoneal irritation are negative. What is the most likely diagnosis in this case?

Answer options

  1. Acute pancreatitis
  2. Perforated stomach ulcer
  3. Acute cholecystitis
  4. Acute appendicitis
  5. Intestinal obstruction
Correct answer

Acute cholecystitis

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