Room #2: The test I could not study for!

My pain was in the upper right hand quadrant and it was quite significant. The insight I gained from my days of preparation for clinical medicine, a second year medical school class, and my clinical training as a general surgery resident, allowed me to consider the differential diagnosis for this pain. The thought of the pain being caused by a renal stone was not out of the question; it was in the differential for the cause of this throbbing discomfort I sustained. In that the sharp and stabbing sensation appeared shortly after eating, other possibilities were to be considered, including cholecystitis (inflammation of the gallbladder from a stone), a gastric or duodenal ulcer, or even appendicitis. The pain exacerbated after eating food supported this potential diagnosis. In my differential diagnosis, was it abdominal discomfort from a pulled muscle following a long run as I had been training for my 13th New York City Marathon? At the time, I was also one week away from an important examination, so the possibly that I was having some gastritis was a possible explanation. I chose to stop eating food that day hoping the gallbladder pain, my initial diagnosis, would resolve or at least improve. Unfortunately, the pain intensity only got worse. My family and I journeyed out to a Bar Mitzvah that day, as I did not want to spoil the festivities, but the increasing level of agony prevented me from staying beyond the welcome reception.