Review Question - QID 212611

A 57-year-old man comes to the clinic complaining of nausea and 1 episode of vomiting during the past day. He denies any precipitating event except for a headache for which he took some acetaminophen yesterday. The headache is described as bilateral, dull, and 8/10 in severity. He has never had such symptoms before. His past medical history is significant for hypertension, biliary colic, and a past hospitalization for delirium tremens when he “tried to quit alcohol cold turkey.” When asked about his current alcohol intake, the patient looks away and mutters “just a couple of drinks here and there.” The patient reports mild abdominal pain that began this morning but denies vision changes, bowel changes, fever, or weight loss. Physical examination demonstrates tenderness at the right upper quadrant (RUQ) that does not worsens with inhalation. What is the most likely explanation for this patient’s symptoms?