A 25-year-old woman presents with upper abdominal pain, nausea, and vomiting after a fatty meal. She has a history of intermittent right upper quadrant pain over the past few months. Ultrasound reveals multiple gallstones in the gallbladder. What is the most likely diagnosis? A) Acute cholecystitis B) Gallbladder dyskinesia C) Choledocholithiasis D) Gallstone pancreatitis E) Biliary colic Correct Answer: E) Biliary colic Explanation: Biliary colic is caused by the intermittent obstruction of the cystic duct by gallstones, leading to episodes of right upper quadrant pain often after meals, especially fatty foods. Acute cholecystitis (A) presents with persistent right upper quadrant pain, fever, and tenderness over the gallbladder. It usually follows a more prolonged course. Gallbladder dyskinesia (B) is an abnormal function of the gallbladder that can lead to pain after eating but does not cause the obstruction seen in biliary colic. Choledocholithiasis (C) refers to gallstones in the common bile duct, leading to jaundice, biliary obstruction, and often pancreatitis. Gallstone pancreatitis (D) occurs when a gallstone blocks the pancreatic duct, leading to acute pancreatitis and elevated pancreatic enzymes. Key Tips for PLAB 1: ✅ Intermittent RUQ pain after fatty meals and gallstones = Biliary colic ✅ Ultrasound confirms gallstones, but persistent symptoms would require further management.
