The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 39-year-old woman comes to the physician because of fever, generalized fatigue, and chills for 1 week. She has been having dull right-side abdominal pain during this period. She has nausea. She has no history of travel outside the United States. She has type 1 diabetes mellitus. Current medications include insulin and an oral contraceptive. She appears ill. Her temperature is 40°C (104°F), pulse is 118/min, and blood pressure is 106/70 mm Hg. On examination, the liver is palpated 2–3 cm below the right costal margin and is tender. There are decreased breath sounds over the right lung base. The remainder of the examination shows no abnormalities. Laboratory studies show: Hemoglobin 14.1 g/dL Leukocyte count 17,100/mm3 Segmented neutrophils 74% Eosinophils 1% Lymphocytes 20% Monocytes 5% Serum Glucose 79 mg/dL Creatinine 1.1 mg/dL Total bilirubin 0.9 mg/dL Alkaline phosphatase 180 U/L AST 69 U/L ALT 100 U/L A right upper quadrant ultrasound is shown. Which of the following is the most appropriate next step in management?"   (A) Discontinue the oral contraceptive   (B) Obtain hepatoiminodiacetic acid scan   (C) Perform endoscopic retrograde cholangiopancreatography   (D) Perform percutaneous drainage "
['(D) Perform percutaneous drainage <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Discontinue the oral contraceptive \n (B) Obtain hepatoiminodiacetic acid scan \n (C) Perform endoscopic retrograde cholangiopancreatography \n (D) Perform percutaneous drainage\n" <> possible answers', '  A 39-year-old woman comes to the physician because of fever, generalized fatigue, and chills for 1 week. She has been having dull right-side abdominal pain during this period. She has nausea. She has no history of travel outside the United States. She has type 1 diabetes mellitus. Current medications include insulin and an oral contraceptive. She appears ill. Her temperature is 40°C (104°F), pulse is 118/min, and blood pressure is 106/70 mm Hg. On examination, the liver is palpated 2–3 cm below the right costal margin and is tender. There are decreased breath sounds over the right lung base. The remainder of the examination shows no abnormalities. Laboratory studies show:\nHemoglobin 14.1 g/dL\nLeukocyte count 17,100/mm3\nSegmented neutrophils 74%\nEosinophils 1%\nLymphocytes 20%\nMonocytes 5%\nSerum\nGlucose 79 mg/dL\nCreatinine 1.1 mg/dL\nTotal bilirubin 0.9 mg/dL\nAlkaline phosphatase 180 U/L\nAST 69 U/L\nALT 100 U/L\nA right upper quadrant ultrasound is shown. Which of the following is the most appropriate next step in management?" <> context@']