Which clinical constellation adds hypotension and altered mental status to Charcot triad, defining Reynolds pentad in acute ascending cholangitis?
Answer and explanation
Correct answer: B. Hypotension and altered mental state
- Step 1: Charcot triad consists of fever, right upper quadrant abdominal pain, and jaundice, indicating bacterial infection within an obstructed biliary tract.
- Step 2: The progression to septic shock characterized by hypotension and neurological depression constitutes Reynolds pentad, indicating life-threatening suppurative cholangitis requiring emergent biliary decompression.
Answer
Hypotension and altered mental state.
Why not the others: Tachypnea and diarrhea are non-specific signs that do not define Reynolds pentad. Hematochezia reflects lower gastrointestinal hemorrhage rather than acute cholangitis. Ascites and hypokalemia reflect chronic portal hypertension rather than the acute systemic hemodynamic collapse of suppurative cholangitis.
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