Which addition converts Charcot's triad into Reynolds' pentad?
- A Hypotension and metabolic acidosis
- B Leucocytosis and raised serum bilirubin
- C Shock and altered sensorium ✓
- D Fever and rigors beyond 39 degrees Celsius
Correct answer: C. Shock and altered sensorium
Explanation
Charcot's triad consists of fever with chills, jaundice and right upper quadrant pain, seen in acute cholangitis. Adding shock and altered mental status gives Reynolds' pentad, which signals suppurative cholangitis and mandates urgent biliary decompression alongside resuscitation. Leucocytosis and acidosis may accompany severe sepsis but are laboratory findings, not part of the classical clinical pentad described by Reynolds and Dargan.
Reference: Sabiston Textbook of Surgery, 21st ed.
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