A 32-Year-Old Man Comes to the Emergency Room (ER) Because

A 32-year-old man comes to the emergency room (ER) because of acute onset left flank pain, hematuria and vomiting.  His pain is relieved with analgesics in the ER.  He has a history of abdominal pain due to Crohn disease, but that pain was always in the right lower quadrant and was never this severe.  His temperature is 36.8°C (98.2°F) , blood pressure is 120/65 mm Hg, pulse is 110/min and respirations are 16/min.  Chest auscultation is clear.  Abdomen is soft and mildly tender over the left flank.  He has no rebound or rigidity.  Bowel sounds are decreased.  A laparotomy scar is present in right lower quadrant.  Which of the following is the most likely cause of his symptoms?

A) Increased recycling of bile salts and fatty acids
B) Increased absorption of oxalate
C) Increased absorption of calcium
D) Increased parathyroid hormone activity
E) Recurrent bacteria infection in the kidney

Correct Answer:

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