53-year-old woman comes to the urgent care clinic with right-sided abdominal pain that started 2 days ago. She describes the pain
as constant, burning, and severe enough to interfere with sleep. There is no associaled nausea, vomiting, or diarrhea. The patient
tried treating the symptoms with a few doses of over-the-counter antacids and ibuprofen, which brought no relief. Her medical history
is significant for breast cancer diagnosed a year ago, for which she underwent a modified radical mastectomy followed by
chemotherapy; the last course was completed 3 weeks ago. On physical examination, her temperature is 36.7 C (98 F), blood
pressure is 120/70 mm Hg, pulse is 80/min, and respirations are 16/min. Her lung fields are clear l o auscultation and her abdomen is
soft and nondistended with no rebound, guarding, or rigidity. The li ver span is 8 cm and the spleen is not palpable. Bowel sounds are
normal. Lightly brushing the skin to the right of the umbilicus elics intense pain. Which of the following additional features is this
patient most likely to develop?
- 0 A. Ascites
- 0 8. Black stool
- 0 C. Cough and hemoptysis
- 0 0. Fever and jaundice
- 0 E. Hollow viscus perforation
- 0 F. Intestinal obstruction
- 0 G. Skin lesions
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