Question

you are called to treat a patient complaining of right upper quadrant pain and pain in the right shoulder. this pain came on shortly after eating a piece of pizza. which of the following organs should you suspect?

spleen.
kidney.
appendix.
gall bladder.

Explanation:

Analyze the clinical presentation

Using the Cholecystitis Pathophysiology knowledge point

• The patient presents with right upper quadrant (RUQ) abdominal pain.
• The pain radiates to the right shoulder, which is a classic presentation of referred pain (Kehr's sign or phrenic nerve irritation).
• The onset occurred shortly after eating a piece of pizza, which is high in fat. Fatty meals trigger the release of cholecystokinin, causing contraction of the gallbladder.

Evaluate the options

• Spleen: Located in the left upper quadrant (LUQ); pathology typically causes LUQ pain or left shoulder referred pain (Kehr's sign).
• Kidney: Typically presents with flank pain radiating to the groin (renal colic).
• Appendix: Located in the right lower quadrant (RLQ); pathology typically presents with periumbilical pain migrating to the RLQ.
• Gallbladder: Located in the RUQ; pathology (like cholecystitis or biliary colic) is characteristically triggered by fatty meals and refers pain to the right shoulder/scapula.

Answer:

• Spleen.
• Kidney.
• Appendix.
• Gall bladder. (Correct answer)