Hepatobiliary Disease USMLE Step 1 Practice Question
A 56-year-old woman with a history of cholecystitis presents with jaundice and severe pruritus for 3 days. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies reveal direct bilirubin 4.2 mg/dL, alkaline phosphatase 320 U/L, and normal transaminases. Abdominal ultrasound shows dilated common bile duct (8 mm) with gallstones; no hepatomegaly noted. Which diagnosis best explains her presentation?
Answer choices
- ACholedocholithiasisCorrect answer
- BGilbert syndrome
- CPrimary biliary cholangitis
- DHemolytic anemia
- EAcute appendicitis
- FPancreatic adenocarcinoma with biliary obstruction
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