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Positive Murphy's sign
Surgery · exam-style practice question with explanation
A 40-year-old woman has right upper quadrant pain and fever. When you press under the right costal margin and she breathes in, she stops inspiring because of pain. What does this suggest?
- A. Acute cholecystitis
- B. Acute appendicitis
- C. Right lower lobe pneumonia
- D. Peptic ulcer disease
Show the answer and explanation
Answer: A. Acute cholecystitis
This is a positive Murphy's sign: an inflamed gallbladder descends on inspiration and hits the examining hand, so the patient catches their breath. It points to acute cholecystitis. Ultrasound is the first imaging test.
Key point: Murphy's sign: inspiratory arrest on palpating the RUQ, suggesting acute cholecystitis.
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