NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 45-year-old female complains of severe, cramping abdominal pain that started suddenly after eating a large fatty meal. She describes the pain as being in the right upper quadrant and radiating to her right shoulder. She is nauseated and has vomited once. Her vital signs are stable. What is the MOST likely cause of her symptoms?
- AAppendicitis.
- BDiverticulitis.
- CCholecystitis.
- DGastroenteritis.
Show answer & explanationAnswer & explanation
Correct answer: C. Cholecystitis.
The patient's symptoms (severe, cramping right upper quadrant pain radiating to the right shoulder, onset after a fatty meal, nausea, vomiting) are classic for cholecystitis, which is inflammation of the gallbladder, often caused by gallstones.
Why the other options are wrong
- A. Appendicitis typically presents with pain starting periumbilically and localizing to the right lower quadrant, usually without a clear association with fatty meals.
- B. Diverticulitis usually causes left lower quadrant pain and is more common in older adults, not typically associated with fatty meals or right upper quadrant pain.
- D. Gastroenteritis typically involves diffuse abdominal pain, diarrhea, and vomiting, but less specific, localized, and radiating pain as described.
Cholecystitis
Inflammation of the gallbladder, usually caused by gallstones blocking the cystic duct, leading to characteristic right upper quadrant pain.
- Pain often triggered by fatty meals.
- Pain typically in the right upper quadrant, can radiate to the right shoulder or back.
- Associated symptoms include nausea, vomiting, fever.
Memory trick: RUQ = Right Up, Quickly Gallbladder!