Hepatobiliary Disease USMLE Step 1 Practice Question
A 67-year-old man with a 40 pack-year smoking history presents with progressive weight loss, painless jaundice, and dark urine over 3 weeks. Vital signs: BP 138/82, HR 88, RR 16, temp 37.2°C, SpO2 98%. Physical examination reveals a palpable, nontender gallbladder and no abdominal pain. Laboratory studies show elevated conjugated bilirubin at 8.2 mg/dL and alkaline phosphatase of 420 U/L. Abdominal ultrasound demonstrates a dilated common bile duct without gallstones. Which of the following is the most likely diagnosis?
Answer choices
- AAdenocarcinoma of the head of the pancreasCorrect answer
- BGallstone pancreatitis
- CGilbert syndrome
- DPrimary biliary cholangitis
- EAcute cholangitis
- FHepatocellular carcinoma with biliary obstruction
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