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Mark is a 45-year-old male who presents with a 24-hour history of RUQ pain. He states the pain started about 1 hour after a large dinner he had with his friends. He has had nausea and on instance of vomiting before presentation. Medical history include Gout, Hypertension, and Deep vein thrombosis (as a result of oral BCPs). His current medications include: Lisinopril 10 mg, Hydrochlorothiazide 25 mg a day, Allopurinol 100 mg daily, and multivitamin daily. Lab values are: Alk Phos 100u/l, direct bilirubin 0.6mg/dl, total bilirubin is 0.8mg/dl. WBC is13, 000/mm3, ALT: 30 U/L, AST: 45 U/L. He is allergic to the following: Latex, Codeine, and Amoxicillin. Physical examination revealed the following: Eyes: EOMI, HENT: Normal GI: bNondistended, minimal tenderness, Skin: bWarm and dry, Neuro: Alert and Oriented. Psych:bAppropriate mood
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