GI — MCQs

An otherwise healthy 56-year-old woman comes to the physician because of a 3-year history of intermittent upper abdominal pain. She has had no nausea, vomiting, or change in weight. Physical examination shows no abnormalities. Laboratory studies are within normal limits. Abdominal ultrasonography shows a hyperechogenic rim-like calcification of the gallbladder wall. The finding in this patient's ultrasonography increases the risk of which of the following conditions?

A 41-year-old G3P3 woman presents with acute on chronic right upper quadrant abdominal pain. She says that her current symptoms acutely onset 8 hours ago after eating a large meal and have not improved. She describes the pain as severe, sharp and cramping in character, and localized to the right upper quadrant. She also describes feeling nauseous. The patient says she has had similar less severe episodes intermittently for the past 2 years, usually precipitated by the intake of fatty foods. She denies any history of fever or jaundice. Vital signs are stable. Physical examination is unremarkable, and laboratory findings show normal liver function tests and normal serum bilirubin and serum amylase levels. Ultrasonography of the abdomen reveals multiple stones in the gallbladder. The patient is managed symptomatically for this episode, and after a few months, undergoes elective cholecystectomy, which reveals multiple stones in her gallbladder as shown in the figure (see image). Which of the following best describes these gallstones?

A 41-year-old woman is referred by her radiation oncologist to the medical genetics clinic. She was recently diagnosed with an infiltrating ductal carcinoma of the breast. She has a previous history of colonic polyps for which she undergoes bi-annual colonoscopy. The maternal and paternal family history is unremarkable for polyps and malignant or benign tumors. However, the patient reports that her 10-year-old son has dark brown pigmentation on his lips, and she also had similar pigmentation as a child. Histology of colonic polyps in this patient will most likely reveal which of the following?