Card 10 / 33: A 65 year old man, on TPN (total parenteral nutrition) for several months due to an obstructing esophageal cancer, complains of intermittent episodes of severe right upper quadrant abdominal pain radiating to the right shoulder. These episodes are associated with nausea and vomiting. A right upper quadrant ultrasound shows a few small gallstones and sludge in the gallbladder. His serum cholesterol level is 290 mg/dl (normal < 200mg/dl). The most likely predisposing factor for this patient’s sludge and gallstones is which of the following?
A) TPN
B) Gender
C) Dehydration
D) Serum cholesterol level
E) Esophageal cancer

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