T. G. is a 48-year-old female who presents with biliary colic. She has had previous episodes but has resisted operation because she is afraid of anesthesia. Today her physical exam reveals a clearly distressed middle-aged female with right upper quadrant pain, nausea, and vomiting. Which of the following findings suggests a complication that requires a surgical evaluation?

Correct Answer: A

Rationale: A leukocyte count of 18,000/µL suggests an elevated white blood cell count, which is indicative of an inflammatory or infectious process. In the context of biliary colic, an elevated white blood cell count could be a sign of complications such as cholecystitis (inflammation of the gallbladder) or choledocholithiasis (bile duct obstruction). These complications may require urgent surgical evaluation and intervention. The other options, although concerning, do not specifically suggest a complication that necessitates immediate surgical evaluation.

Correct Answer: D

Rationale: Thrombophlebitis involves the formation of non-detachable clots within inflamed veins.

Correct Answer: A

Rationale: Epinephrine is not indicated as part of emergency intervention for bradycardic abnormalities in posttransplant patients. Epinephrine is a medication usually used in cases of cardiac arrest or severe anaphylaxis, and it can potentially exacerbate bradycardia in patients with preexisting bradyarrhythmias. In this scenario, other options such as isoproterenol, external pacemaking, and atropine are more appropriate choices for managing bradyarrhythmias in a posttransplant patient.

Correct Answer: C

Rationale: Isoniazid is the drug of choice for treating neonatal tuberculosis.

Correct Answer: B

Rationale: Postmaturity refers to pregnancies that last beyond 42 weeks.