Afghanistan Specialization Entry Exam

Practice session

A 44-year-old female presents with severe, steady right upper quadrant (RUQ) abdominal pain radiating to the right scapula for 8 hours, accompanied by nausea, vomiting, and a temperature of 38.4°C. On palpation of the RUQ during deep inspiration, there is abrupt inspiratory arrest due to severe pain (positive Murphy's sign). What is the initial imaging modality of choice to establish the diagnosis?

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