ANSWER 5 =A
The finding of acute onset of right lower quadrant should suggest in this patient an intestinal, gynecologic or urologic disorder. Rarely, this symptom may be explained by lumbar radiculopathy or an unerupted herpes zoster. The remainder of the clinical findings suggest an inflammatory process. The patient need not be sent to surgery without a clinical diagnosis. Furthermore, the EKG reveals CLBBB with a QRS greater than 120 msc. Therefore, an acute MI should be ruled out in terms of other criteria such as CPK, Troponins, and echocardiography