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Acute cholecystitis — USMLE Step 2 CK MCQ

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EasySurgeryAcute cholecystitisUSMLE Step 2 CK

A 35-year-old African American man comes to the clinic because of progressive symptoms. History and focused examination are notable for right upper quadrant pain, fever, leukocytosis, and sonographic gallstones with wall thickening. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely diagnosis?

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Correct answer: B — Acute cholecystitis

The vignette describes Acute cholecystitis, supported by right upper quadrant pain, fever, leukocytosis, and sonographic gallstones with wall thickening. Acute cholecystitis is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: SAGES 2020 Cholecystitis Guideline