A 77-year-old woman comes to the physician because of a 2-day history of cramping abdominal pain and

Discussion in 'USMLE Step 2 CK' started by samuel, Nov 12, 2014.

  1. samuel

    samuel New Member

    A 77-year-old woman comes to the physician because of a 2-day history of cramping abdominal pain and distention accompanied by nausea and vomiting. She is otherwise healthy and has no history of abdominal operations. Her temperature is 37.4 C (99.4 F), blood pressure is 110/86 mm Hg, pulse is 112/min, and respirations are 24/min. Cardiopulmonary examination shows no abnormalities. Examination of the abdomen shows distention and mild diffuse tenderness; bowel sounds are high-pitched. An x-ray film of the abdomen shows air-fluid levels throughout the small bowel and air in the liver; there is no gas in the colon or free air. Which of the following is the most likely diagnosis?

    A
    ) Adhesive small-bowel obstruction

    B
    ) Cecal cancer

    C
    ) Gallstone ileus

    D
    ) Intussusception

    E
    ) Mesenteric infarction

    F
    ) Ruptured appendicitis

    G
    ) Small bowel lymphoma

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