NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 35-year-old male presents with severe abdominal pain that started suddenly after eating a large, fatty meal. He describes the pain as a sharp, constant ache in the right upper quadrant, radiating to his right shoulder. He is nauseated and has vomited once. His vital signs are stable. What is the MOST likely cause of his symptoms?
- ACholecystitis.
- BGastroenteritis.
- CPancreatitis.
- DAppendicitis.
Show answer & explanationAnswer & explanation
Correct answer: A. Cholecystitis.
The patient's symptoms (sudden onset of severe right upper quadrant pain, radiation to the right shoulder, onset after a fatty meal, nausea/vomiting) are classic for acute cholecystitis, which is inflammation of the gallbladder, often caused by gallstones obstructing the cystic duct.
Why the other options are wrong
- B. Gastroenteritis usually involves diffuse abdominal cramping, diarrhea, and vomiting, rather than localized severe RUQ pain.
- C. Pancreatitis typically presents with severe epigastric pain radiating to the back, often associated with alcohol abuse.
- D. Appendicitis typically presents with periumbilical pain migrating to the right lower quadrant.
Acute Cholecystitis
Acute cholecystitis is the inflammation of the gallbladder, usually caused by gallstones blocking the cystic duct. It is often triggered by fatty meals.
- Primary symptom is severe, constant pain in the right upper quadrant.
- Pain may radiate to the right shoulder or back.
- Often associated with nausea, vomiting, and fever.
- Onset typically follows consumption of fatty foods.
Memory trick: Fatty meal, RUQ pain, shoulder ache? Think 'Gall'!