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A patient presents to the ER with RUQ epigastric pain that is worse for 1-2 hours

0 years old | Male

Vignette:

A patient presents to the ER with RUQ epigastric pain that is worse for 1-2 hours after fatty meals. They are positive for nausea and a sensation of heaviness or pressure (what ever the hell that means). What are you suspicious of?

Summary:

RUQ pain | epigastric pain | worse after fatty meals | nausea | heaviness | pressure

Dx:

Biliary Colic

Ref:

https://quizlet.com/86714826/general-abdominal-pain-patient-vignettes-flash-cards/?__cf_chl_captcha_tk__=640bed634bb62869f9c40b390ae86cea9c023c3b-1617526521-0-AeB8ZXsrJfqJLRsdXRUPHe1lpCNEDSSfIMW19wKJqBkqH4h-xly7wDpqny5bigyZnFlJRZi1Ux_a4I5vIF2GHoHUooeO0xvkEv76d4OouRdKpxqnqRu-I3P7qfdOb27Ou2qPOXPvb--IgjzAfRFLvXF9A0BNrMueHaXzcr3KJASu_80E2ZdGpkFNWlO0g_9vDQz2RP4rRLlZT8AEn1NT0agfmqKFKGTYNhGFXZZ9Cmb8U34JEID4Y-wgfvwx6eJGiL0giYdnR4X_y3-PEIW1CVc73EWxEwSapbchHy0mt8DzheeQ-NZDDncNXTwUmq_KY_QF2W9pN-o1vzTxUvhADxmMazPK8rr3VYiQAjxMCaPw3mbcvzViYzpvNoP4POd338QY6nUa63CCzDsqt2857NrXoS57Sca_Ib4vCkiK1tz_gieXL4F0ZQvJ9Ahb_5yQufkjJGwwwGfIUS7m7T_9YKCO-CBIS70l5IXmjm922i2orrpAyWbeUUnjokooPLkl8V4fMv2tPn7NHZABj78VXYwngvmfNqeedP8iHeGeqcwxVYN8Kp8xqaRmNKATXk_017KrkmzJ_pk22nWycAO1TWzs53kwVmqGLr-RBXdosBxES_lHV2aMrAUh7ZpGcqr-GkZzA1wE6ERVyb3UzDJ3yxWNB4az77rWHks_cPONAfQ9crwEQ_69tYwRqbdZWyU1acOUK6rna-EuHxlL5OqxS4qSr1vOaOHN_jUhIKZU38_W

Rank

Disease

Weight

1 Gastroparesis 252.0
2 Acute Pancreatitis 249.0
3 Acute Cholecystitis 248.0
4 Emphysematous cholecystitis 248.0
5 biliary SOD 226.0
6 Sphincter of Oddi Dysfunction 218.0
7 pancreatic SOD 218.0
8 biliary colic 213.0
9 Gastric Outlet Obstruction 205.0
10 Gallstone pancreatitis 194.0
11 Gallbladder Dyskinesia 192.0
12 Choledocholithiasis 189.0
13 pancreatic cancer 189.0
14 Chronic Pancreatitis 181.0
15 Gallstones 178.0
16 Acute fatty liver of pregnancy 178.0
17 Peptic Ulcer 176.0
18 Mesenteric ischemia 168.0
19 Hiatus hernia 166.0
20 Acute Appendicitis 158.0
21 Gastritis 155.0
22 Sigmoid volvulus 154.0
23 Acute peptic ulcer 152.0
24 Chronic Cholecystitis 151.0
25 Dyspepsia 151.0
26 mucosal Eosinophilic gastroenteritis 149.0
27 Gastric Ulcer 145.0
28 Duodenal Ulcer 145.0
29 Hereditary Angioedema 145.0
30 Esophagitis 142.0
31 Gastric cancer 139.0
32 Acute Cholangitis 137.0
33 Acute perforated appendicitis 136.0
34 Cholecystitis 133.0
35 Liver disease 130.0
36 Gastroesophageal reflux disease 130.0
37 Preeclampsia 130.0
38 Acalculous Cholecystitis 129.0
39 Crohn Disease 129.0
40 chronic acalculous cholecystitis 128.0
41 Pyogenic Liver Abscess 123.0
42 Intussusception 122.0
43 Acute Hepatitis 120.0
44 Intestinal Obstruction 119.0
45 Rocky Mountain spotted fever 118.0
46 Chronic bacterial prostatitis 116.0
47 Choledochal Cyst 115.0
48 Giardiasis 113.0
49 Muscle Layer Eosinophilic gastroenteritis 113.0
50 Migraine headache in adults 113.0
51 Ovarian Cancer 111.0
52 Sarcoidosis 110.0
53 Lactose intolerance 110.0
54 Alcoholic hepatitis 109.0
55 Extraintestinal Entamoeba histolytica amebiasis 109.0
56 Inguinal hernia 109.0
57 Gallbladder cancer 108.0
58 Acute Liver Failure 105.0
59 Irritable Bowel Syndrome 105.0
60 Autoimmune hepatitis 103.0
61 Zollinger-Ellison Syndrome 100.0
62 Adrenal crisis 99.0
63 Intestinal Pseudo Obstruction 98.0
64 Ovarian Hyperstimulation Syndrome 96.0
65 Liver Cirrhosis 95.0
66 Biliary cirrhosis 95.0
67 Primary biliary cirrhosis 95.0
68 Ileus 95.0
69 Klebsiella pneumoniae liver abscess 92.0
70 Peritoneal dialysis associated peritonitis 91.0
71 Ectopic Pregnancy 91.0
72 Amebic Liver Abscess 90.0
73 Asthma 90.0
74 Acetaminophen overdose 89.0
75 Thrombotic thrombocytopenic purpura 89.0
76 Non-ST-elevation myocardial infarction 88.0
77 Addison Disease 88.0
78 Secondary Peritonitis 87.0
79 Foreign body ingestion 86.0
80 Panic disorder in adults 86.0
81 Listerial gastroenteritis 85.0
82 Alcoholic Liver Disease 84.0
83 Hepatocellular carcinoma 83.0
84 Anaphylaxis 83.0
85 Cholangiocarcinoma 80.0
86 Diabetic Ketoacidosis 80.0
87 Breast Cancer 80.0
88 Anthrax 80.0
89 Ovarian and fallopian tube torsion 79.0
90 Pyelonephritis 79.0
91 Bacterial gastroenteritis 78.0
92 Prinzmetal angina 78.0
93 subserosal eosinophilic gastroenteritis 77.0
94 Primary ciliary dyskinesia 77.0
95 Primary sclerosing cholangitis 76.0
96 Acute intermittent porphyria 76.0
97 Autosomal Dominant Polycystic Kidney Disease 76.0
98 Eosinophilic gastroenteritis 74.0
99 Polyarteritis nodosa 73.0
100 Hypertriglyceridemia 73.0
101 Annular pancreas 72.0
102 Acute viral meningitis 72.0
103 Viral Gastroenteritis 72.0
104 Chronic Clonorchiasis 71.0
105 Gastric Volvulus 71.0
106 Systemic lupus erythematosus 71.0
107 Diverticulitis 71.0
108 Spontaneous bacterial peritonitis 71.0
109 Malt lymphoma 71.0
110 Acute pyelonephritis in adults 71.0
111 Ulcerative Colitis 70.0
112 Ovarian Torsion 70.0
113 Ruptured ectopic pregnancy 69.0
114 Hyperparathyroidism 69.0
115 Intrahepatic cholestasis of pregnancy 68.0
116 Hemolytic uremic syndrome 68.0
117 Non-small cell lung cancer 68.0
118 Motion Sickness 68.0
119 Budd Chiari Syndrome 67.0
120 Chronic Myeloid Leukemia 67.0
121 Systemic sclerosis 67.0
122 Meckel diverticulum 67.0
123 Type 1 Diabetes mellitus 67.0
124 Stable angina 67.0
125 Meniere disease 67.0
126 Pancreatic Pseudocyst 66.0
127 Churg-Strauss Syndrome 66.0
128 Intra-abdominal abscess 66.0
129 Typhoid infection 66.0
130 Non-cholera Vibrio infections 66.0
131 ST-elevation myocardial infarction 65.0
132 Alcoholic Liver Cirrhosis 65.0
133 Aseptic meningitis 65.0
134 Rumination Syndrome 64.0
135 Brucellosis 64.0
136 Migraine 62.0
137 Food poisoning 61.0
138 Adrenal Suppression 61.0
139 Salmonella infection 61.0
140 Infectious mononucleosis 60.0
141 Pheochromocytoma 60.0
142 Analgesic nephropathy 60.0
143 Short bowel syndrome 59.0
144 Heparin-induced thrombocytopenia 59.0
145 Kawasaki disease 59.0
146 Endometriosis 59.0
147 Labyrinthitis 59.0
148 Acute Clonorchiasis 58.0
149 Clonorchiasis 58.0
150 Familial adenomatous polyposis syndrome 58.0
151 Chronic pelvic pain in women 58.0
152 Hypercalcemia 58.0
153 Campylobacter infection 57.0
154 Peutz-Jeghers Syndrome 57.0
155 Nasal polyps 57.0
156 Diabetes Mellitus 56.0
157 Common cutaneous drug reactions 55.0
158 Angle Closure Glaucoma 55.0
159 Chronic heart failure 54.0
160 Varicose veins 54.0
161 Amphetamine use disorder 53.0
162 Inflammatory Bowel Diseases 52.0
163 Shigellosis 52.0
164 Celiac Disease 51.0
165 Papilledema 51.0
166 Mirizzi Syndrome 50.0
167 Eclampsia 50.0
168 Graves Disease 50.0
169 End Stage Renal Disease 50.0
170 Milk-alkali syndrome 50.0
171 Subdural hematoma 50.0
172 Acute Milk-alkali syndrome 50.0
173 Chronic Milk-alkali syndrome 50.0
174 Ruptured ovarian cyst 48.0
175 Primary Myelofibrosis 48.0
176 Leiomyomas 48.0
177 Foodborne E coli infection 48.0
178 Gilbert syndrome 48.0
179 Cystic Fibrosis 47.0
180 Stable ischemic heart disease 47.0
181 Kidney stones 46.0
182 Chronic pyelonephritis 46.0
183 Renal and perinephric abscess 45.0
184 Henoch-Schonlein purpura 45.0
185 Hepatorenal Syndrome 44.0
186 Colorectal cancer 44.0
187 Insect bites and stings 44.0
188 Acute disseminated encephalomyelitis 44.0
189 Autoimmune Pancreatitis 43.0
190 Fibromyalgia 43.0
191 Wilson disease 42.0
192 Acute Lymphoblastic leukemia in children 41.0
193 Fungal meningitis 41.0
194 Gallbladder Empyema 40.0
195 Bladder Cancer 40.0
196 Epiploic appendagitis 40.0
197 Hyperthyroidism 40.0
198 Acute heart failure 40.0
199 Bacterial pharyngitis 39.0
200 Upper gastrointestinal hemorrhage 39.0
201 Lower gastrointestinal hemorrhage 39.0
202 Gastrointestinal Hemorrhage 39.0
203 Lung Cancer 38.0
204 Biliary cyst 38.0
205 Common cold(adults) 38.0
206 Hemorrhagic stroke 37.0
207 Ischemic stroke 37.0
208 Malaria 36.0
209 Aortic Dissection 36.0
210 Gestational diabetes mellitus 35.0
211 Obstructive Sleep Apnea 35.0
212 Amyloidosis 35.0
213 Amebiasis 34.0
214 Diabetic Neuropathy 34.0
215 Mallory-Weiss syndrome 34.0
216 Unstable angina 34.0
217 Clostridium difficile infection 34.0
218 Diabetic Kidney Disease 34.0
219 Toxic Megacolon 33.0
220 Tuberculous Peritonitis 33.0
221 Hyperprolactinemia 33.0
222 Acute Rhinosinusitis 33.0
223 Intraperitoneal bleeding 32.0
224 Anemia of chronic disease 32.0
225 Cholera 32.0
226 Splenic Infarction 32.0
227 Acute bacterial meningitis in adults 32.0
228 Cushing syndrome 30.0
229 Testicular cancer 30.0
230 Ruptured Tuboovarian abscess 29.0
231 Endometrial cancer 29.0
232 Type 2 Diabetes mellitus 29.0
233 Hypothyroidism 28.0
234 Intestinal Entamoeba histolytica amebiasis 28.0
235 Limited cutaneous systemic sclerosis 28.0
236 Gastroenteritis 27.0
237 Pneumonia 27.0
238 Transient ischemic attack 27.0
239 Sunburn 26.0
240 Chronic Hepatitis 25.0
241 Acute Lymphocytic Leukemia in Adults 22.0
242 Hyperosmolar Hyperglycemic state 22.0
243 Alcoholic Fatty Liver 22.0
244 Anaplastic thyroid cancer 21.0
245 Systemic vasculitis 21.0
246 Abdominal compartment syndrome 20.0
247 Acute pericarditis 20.0
248 Travelers diarrhea 20.0
249 Adrenocortical carcinoma 19.0
250 Multiple Myeloma 19.0
251 Herpes zoster 19.0
252 COVID19 18.0
253 Autosomal Recessive Polycystic Kidney Disease 18.0
254 anterior ischemic optic neuropathy 18.0
255 Psychogenic polydipsia 18.0
256 Periorbital and orbital cellulitis 18.0
257 Secondary hyperparathyroidism 18.0
258 Acute bacterial rhinosinusitis 18.0
259 Cryptococcosis 18.0
260 Intestinal malrotation 17.0
261 Multiple endocrine neoplasia 2B 17.0
262 Influenza 17.0
263 Osteoporosis 16.0
264 Gout 16.0
265 Multiple endocrine neoplasia 2A 16.0
266 Aortic coarctation 16.0
267 Hereditary hemochromatosis 15.0
268 Dubin-Johnson syndrome 15.0
269 Urinary Tract Obstruction 15.0
270 Bed bugs 15.0
271 Granulomatosis with polyangiitis 14.0
272 Aortic stenosis 13.0
273 Cryptorchidism 13.0
274 Allergic rhinitis 13.0
275 Phenylketonuria 13.0
276 Ascites 12.0
277 Mitral Stenosis 12.0
278 Glomerulonephritis 12.0
279 Rheumatoid Arthritis 12.0
280 Hypoparathyroidism 12.0
281 Acute Myeloid Leukemia in adults 12.0
282 Chronic Lymphocytic Leukemia 12.0
283 Premature labor 11.0
284 Acute otitis media 11.0
285 Toxic thyroid adenoma 11.0
286 Acromegaly 11.0
287 Atopic dermatitis 11.0
288 Familial Mediterranean fever 10.0
289 Acute respiratory failure 9.0
290 Acute bacterial meningitis in children 9.0
291 Splenic abscess 8.0
292 Guillain-Barre syndrome 8.0
293 Pulmonary Embolism 8.0
294 Paraneoplastic Syndromes 7.0
295 Achalasia 7.0
296 Drowning 7.0
297 Umbilical hernia 7.0
298 Acute atrial fibrillation 7.0
299 Hypogammaglobulinemia 7.0
300 Chlamydia pneumoniae infection 6.0
301 Non-alcoholic Fatty Liver Disease 5.0
302 Renal Cell Carcinoma 5.0
303 Kartagener syndrome 5.0
304 Dacryocystitis 5.0
305 Acute Bronchitis 2.0
306 Diabetic Amyotrophy 2.0
307 Common cold(children) 2.0
308 Alopecia areata 1.0
309 Ankylosing spondylitis 1.0
310 Hyperaldosteronism 1.0
311 Hemorrhoids 0.0
312 Abetalipoproteinemia 0.0
313 Immune thrombocytopenia 0.0
314 Conjunctivitis 0.0
315 Epidemic keratoconjunctivitis 0.0
316 Bacterial conjunctivitis 0.0
317 Viral conjunctivitis 0.0
318 Allergic conjunctivitis 0.0
319 Ligneous conjunctivitis 0.0
320 Vernal keratoconjunctivitis 0.0
321 Atopic keratoconjunctivitis 0.0
322 Noninfectious nonallergic conjunctivitis 0.0
323 Acute epididymitis 0.0
324 Acute Cystitis(Men) 0.0
325 Recurrent aphthous stomatitis 0.0
326 Discogenic low back pain 0.0