Question

A 45-year-old woman presents with severe right upper quadrant pain, fever 38.5°C, and jaundice. BP 100/60, HR 108. LFTs: cholestatic pattern. Ultrasound shows gallstones and dilated CBD. What is the most appropriate initial management?

Accepted Answer

ERCP with biliary decompression plus IV antibiotics

Answer

Elective laparoscopic cholecystectomy in 6 weeks

Answer

Start oral ciprofloxacin and outpatient review

Answer

MRCP then observe

Answer

Percutaneous cholecystostomy

Practice question

A 45-year-old woman presents with severe right upper quadrant pain, fever 38.5°C, and jaundice. BP 100/60, HR 108. LFTs: cholestatic pattern. Ultrasound shows gallstones and dilated CBD. What is the most appropriate initial management?