Answer: B - In this patient with risk factors for biliary colic and gallstones (female, 40s , obese), her symptoms of RUQ pain and nausea are strongly suggestive of biliary colic due to gallstones, which is confirmed on RUQ ultrasound. Patients presenting with biliary colic are managed with opiate analgesics and NSAIDs and observed until pain remits (usually within 5 hours). The patient can then be discharged home with a referral for definitive treatment by laparoscopic cholecystectomy.
Hospital admission and empiric antibiotics are not indicated in the setting of biliary colic. Further imaging is not warranted given the lack of concerning findings on ultrasound and the overall stable clinical picture.
