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Acute cholecystitis — SCE Acute Medicine MCQ

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EasyAcute GI PresentationsAcute cholecystitisSCE Acute Medicine

A 49-year-old woman is assessed on the acute medical unit. She has constant right upper quadrant pain, fever and a positive Murphy sign. Ultrasound shows gallstones and gallbladder wall thickening. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: B — Acute cholecystitis

Acute cholecystitis is the best answer because fever, Murphy sign and ultrasound inflammation indicate acute cholecystitis. Community-acquired pneumonia is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Cholecystitis pain is persistent rather than brief biliary colic.

Reference: NICE CKS gallstones