A 30 year old lady with fever and pain in right hypochondrium with breath catch up upon palpation. Clinical diagnosis:

Ans. (b) Acute cholecystitisRef: Sabistan 19th ed. /1847ACUTE CHOLECYSTITIS* Acute cholecystitis is inflammation of gall bladder and is related to gallstones in 90-95% of cases.* Characteristic triad of cholecystits: RUQ pain + Fever + Leucocytosis* Obstruction of the cystic duct leading to biliary colic is the initial event in acute cholecystitisClinical presentation* RUQ pain of much longer duration than biliary colic, is the MC symptom* Other common symptoms: Fever, nausea, and vomiting* Upon Physical examination: RUQ tenderness and guarding are usually present inferior to the right costal margin.* Murphy's sign: Inspiratory arrest with deep palpation in the RUQ in acute cholecystitis.* Boas sign: Hyperesthesia below right scapula in acute cholecystitis