A 23 year old, overweight, black woman with a history of hemolytic anemia presents to the emergency department with fever and right upper quadrant pain. A right upper quadrant ultrasound is performed which demonstrates gallstones, a thickened gallbladder wall, and pericholecystic fluid. which patient characteristic puts her at higest risk of developing acute cholecystitis?a.female sexb.young agec.ethnicityd.patients with hemolytice.anemiaf.obesity

Acute cholecystitis is the inflammation of the gallbladder, an organ whose main function is to act as a reservoir of bile (a substance made by the liver which helps digest fats). The pathophysiology of this disease is characterized by the presence of stones in the gallbladder, known as gallstones, which block the duct, obstructing the exit of this fluid and favoring inflammation/infection of the organ.

To answer this question, one has to know the risk factors of producing gallstones. An easy way to remember is with the ”F” rule:

Female: Women are more affected than men
Forty: Refers to the age that the patient has higher risk
Fertile: Women who had multiple pregnancies (due to the high concentration of estrogens, which promote the production of gallstones)
Fat: Obese patients have higher concentration of steroid hormones, promoting production of gallstones
Fair: Normally fair skinned people tend to have increased risk.

Additionally, hemolytic anemia is associated with production of pigmented gallstones due to the increased breakdown of red blood cells.

If one had to chose one answer for this specific case, the most likely answer would be hemolytic anemia, since this patient is relatively young and has not been exposed to increased concentration of steroid hormones for a long time In her lifespan. Nevertheless, female sex and obesity still are technically correct answers.