Hepatobiliary Disease USMLE Step 1 Practice Question
A 63-year-old woman with known cholelithiasis presents with fever, jaundice, and right upper quadrant pain. Vital signs show BP 88/54, HR 118, RR 22, temperature 39.2°C, and SpO2 98% on room air. She is increasingly confused. Laboratory studies reveal elevated transaminases and direct hyperbilirubinemia; abdominal ultrasound shows dilated intrahepatic bile ducts. She denies recent antibiotic use. Which of the following is the most likely diagnosis?
Answer choices
- AAcute cholecystitis
- BAcute cholangitisCorrect answer
- CPrimary biliary cholangitis
- DBiliary colic
- EPancreatic adenocarcinoma
- FSpontaneous bacterial peritonitis
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.