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Author: Laurence Scott Bailen, M.D.

1. Question 1

A 33 year-old woman is 3 months post-partum after delivering a healthy baby boy. She complains of intermittent episodes of right upper quadrant pain. An abdominal ultrasound shows numerous gallstones in the gallbladder.

Which of the following best explains the pathogenesis of this patient’s gallstones?

  • Stasis of bile flow leading to pigment stones

  • Supersaturation of bile with bile acids

  • Supersaturation of bile with cholesterol

  • Supersaturation of bile with lecithin

  • High serum cholesterol level

2. Question 2

A 68 year-old woman is admitted to the hospital with 3 days of right upper quadrant pain radiating to the back accompanied by fevers. She has an ultrasound which shows a thickened gallbladder wall and numerous gallstones in the gallbladder. The bile duct is not dilated.

The most likely cause of this patient’s symptoms is which of the following?

  1. Acute pancreatitis

  2. Acute cholangitis

  3. Acute gallstone ileus

  4. Acute hepatitis

  5. Acute cholecystitis

3. Question 3

You are putting together a patient education pamphlet on gallstones. There is a section on risk factors for gallstones.

Which of the following will you most likely include in the section on risk factors for cholesterol gallstones?

  1. Alcohol use

  2. High serum cholesterol

  3. Diabetes mellitus

  4. Rapid weight loss

  5. Sickle cell disease