Hepatobiliary Disease USMLE Step 1 Practice Question
A 43-year-old woman with a history of gallstones presents with severe epigastric pain radiating to the back, nausea, and vomiting for 6 hours. Vital signs show BP 128/82 mmHg, HR 102/min, RR 20/min, temperature 38.2°C, and SpO2 98% on room air. Serum lipase is 1,240 U/L (markedly elevated). Abdominal examination reveals epigastric tenderness without rebound. Which of the following findings is most likely to be present on physical examination if this disease becomes severe?
Answer choices
- APruritic vesicles on extensor surfaces
- BPeriumbilical ecchymosisCorrect answer
- CRebound tenderness localized to McBurney point
- DPainless jaundice with palpable gallbladder
- EAuscultatory abdominal bruit that worsens after meals
- FGrey Turner sign (flank ecchymosis) with cullen sign
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