Question:
While performing an abdominal examination on a 42 year old woman in your office, she suddenly stops inspiratory effort during deep palpation of the right upper quadrant. Of which of the following problems is the most suggestive?
A. Hepatitis
B. Gallstones
C. Cholecystitis
D. Pancreatitis
E Right sided renal calculi
Answer:
C
The specific site of tenderness is classic for many sources of abdominal pain. Sudden cessation of inspiratory effort during deep palpation of right upper quadrant is called 'Murphy sign' and is suggestive of acute cholecystiits.
Hapatitis and gall stones may cause right upper quadrant tenderness but generally do not elicit murphy's sign. Pain caused by pancreatitis often radiates to the back. pain from renal calculi often radiates to shoulder.
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