Rotations 2.0 Episode 38 Diverticulitis

Episode 38 Diverticulitis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Breaking Free by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 37 Cholelithiasis

Question 1: Pathophysiology and Risk Factors

A 45-year-old woman presents with intermittent right upper quadrant pain after meals. She has a BMI of 32 and is on estrogen-containing oral contraceptives. Ultrasound confirms the presence of gallstones. Which of the following best explains the pathophysiology of her condition?

B. Supersaturation of bile with cholesterol leading to crystal formation

Question 2: Diagnostic Imaging

A 60-year-old man presents with fever, jaundice, and right upper quadrant pain. Labs show elevated bilirubin and alkaline phosphatase. Ultrasound reveals gallstones but no ductal dilation. Which imaging modality is most appropriate to both diagnose and treat a suspected common bile duct obstruction?

C. Endoscopic retrograde cholangiopancreatography (ERCP)

Question 3: Pharmacologic Therapy

A patient with asymptomatic cholesterol gallstones is not a surgical candidate. Which of the following pharmacologic agents is most appropriate for attempting gallstone dissolution?

C. Ursodeoxycholic acid (ursodiol)

Paper for Next Week:

Mariko Hojo, Tomoyoshi Shibuya and Akihito Nagahara, Management of Chronic Constipation: A Comprehensive Review, Intern Med 64: 7-15, 2025

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