Assignment task: A 55-year-old woman is complaining of right upper quadrant pain for the past 5 hours. She said she has had two or three similar episodes in the past; however, thy only lasted 1 hour, and the pain was not as severe as with this episode. She thought the prior episodes were due to heartburn, and she has taken over-the-counter antacids with some relief but this time she has not had relief. This episode is rated as an 8 of 10 scale (0 no pain, 10 severe). The pain is constant and does not radiate. She says the pain started a few hours after she had lunch (states she at a fast-food burger). She feels nauseous but has not vomited. She has been getting chills but also feels sweaty. She feels warm but does not know if she has a fever (has not checked at home).
PMHx: Type 2 DM and dyslipidemia. Medications: metformin 1,000mg po BID, estrogen/progestin hormone replacement therapy 0.3mg/1.5mg tablet po QD.
Social Hx: non-smoker, denies alcohol intake; works as cashier in grocery store; married; no children.
Vital signs: BP 140/80 mmHg, P 110, R 20, T 1010 BMI 31 kg/m2
Answer the following questions pertaining to this case:
Q1. What is the most likely diagnosis based on this history, vital signs, and body mass index?
Q2. What are the data to support the diagnosis chosen in #1?
Q3. What are the expected physical exam findings?
Q4. What are the expected findings on a complete blood count and abdominal ultrasound that would support the most likely diagnosis?