Capacity and refusal after overdose — ACEM Fellowship MCQ

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HardPsychiatric emergenciesCapacity and refusal after overdoseACEM Fellowship

A 45-year-old has right-upper-quadrant pain, fever, jaundice and hypotension. Which diagnosis best fits this presentation?

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Correct answer: B — Acute cholangitis

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

A is correct. Pain, fever and jaundice suggest acute cholangitis, and hypotension indicates severe infection. Urgent hospital assessment, antimicrobial therapy and biliary-decompression planning are required. B generally lacks fever and jaundice. C, D and E do not fit this septic biliary presentation.

Reference: Royal Australian College of General Practitioners: Biliary pain—work-up and management: https://www.racgp.org.au/afp/2013/july/biliary-pain