An obese 42 year old female presents with steady aching pain…

An obese 42 year old female presents with steady aching pain to RUQ of the abdomen with nausea and vomiting. She states that the pain has been constant for several days and is now moving into her right shoulder. She reports that it hurts to take a deep breath. She states that she had recently started doing hot yoga, but she had to stop because of the pain. Upon physical examination you find the patient stops breathing on inspiration when you palpate the RUQ with your thumb and fingers hooked under the costal margin. What does this indicate?  :

Linda is a middle age women who experienced an acute onset e…

Linda is a middle age women who experienced an acute onset excruciating pain which started in the epigastric area. The pain eventually moved across her abdomen and radiated to her back. She states that the only thing that makes the pain better is leaning forward.  Which is most likely, given this presentation?