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Acute cholecystitis — MCCQE Part 1 MCQ

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ModerateAbdominal PainAcute cholecystitisMCCQE Part 1

A 49-year-old woman has right upper-quadrant pain, fever and vomiting. Murphy sign is positive; ultrasound shows gallstones, gallbladder wall thickening and pericholecystic fluid. Which of the following is the most appropriate next step?

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Correct answer: D — Admit for antibiotics, analgesia and early laparoscopic cholecystectomy

Fever, Murphy sign and ultrasound findings confirm acute cholecystitis, which needs admission, antibiotics and early cholecystectomy when feasible. Ursodeoxycholic acid is not definitive acute management. Outpatient delay and non-biliary treatments risk perforation or sepsis.

Reference: Canadian Association of General Surgeons practice; Tokyo Guidelines used in Canadian care