system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A previously healthy 31-year-old woman comes to the emergency department because of sudden, severe epigastric pain and vomiting for the past 4 hours. She reports that the pain radiates to the back and began when she was having dinner and drinks at a local brewpub. Her temperature is 37.9°C (100.2°F), pulse is 98/min, respirations are 19/min, and blood pressure is 110/60 mm Hg. Abdominal examination shows epigastric tenderness and guarding but no rebound. Bowel sounds are decreased. Laboratory studies show:
Hematocrit 43%
Leukocyte count 9000/mm3
Serum
Na+ 140 mEq/L
K+ 4.5 mEq/L
Ca2+ 9.0 mg/dL
Lipase 170 U/L (N = < 50 U/L)
Amylase 152 U/L
Alanine aminotransferase (ALT, GPT) 140 U/L
Intravenous fluid resuscitation is begun. Which of the following is the most appropriate next step in management?"
assistant
Right upper quadrant abdominal ultrasound