A 45-year-old female presents to the emergency department with a 24-hour history of sharp, right upper quadrant abdominal pain radiating to her right shoulder, nausea, and fever. Her vitals are: BP 135/85 mmHg, HR 102 bpm, RR 19/min, Temp 101.3°F (38.5°C), and SpO2 97% on room air. On examination, you note a positive Murphy's sign. Laboratory results show a mild leukocytosis. Suspecting cholecystitis, what is the most appropriate initial diagnostic test to order?
Hepatobiliary (HIDA) scan
Magnetic resonance cholangiopancreatography (MRCP)
A right upper quadrant ultrasound is the most appropriate initial diagnostic test for suspected cholecystitis. It is highly sensitive and specific for detecting gallstones, biliary sludge, gallbladder wall thickening, and pericholecystic fluid, which are indicative of cholecystitis. An abdominal CT scan may be useful for assessing complications or alternative diagnoses but is not the first-line imaging modality for cholecystitis. A hepatobiliary (HIDA) scan is typically reserved for cases where the diagnosis is uncertain after ultrasound. MRCP is also used in complex cases or when further biliary tree assessment is needed, but not as the initial test.
Ask Bash
Bash is our AI bot, trained to help you pass your exam. AI Generated Content may display inaccurate information, always double-check anything important.
What are the indications for using a right upper quadrant ultrasound in suspected cholecystitis?
Open an interactive chat with Bash
Why is an abdominal CT scan not the first choice for diagnosing cholecystitis?
Open an interactive chat with Bash
What does a positive Murphy's sign indicate in the context of cholecystitis?
Open an interactive chat with Bash
BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
Your Score:
Report Issue
Bash, the Crucial Exams Chat Bot
AI Bot
Loading...
Loading...
Loading...
Nursing and Medical Assistants Package Join Premium for Full Access