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Choledocholithiasis — ABFM Board MCQ

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HardGI/HepatologyCholedocholithiasisABFM Board

A 44-year-old woman has episodic right upper quadrant pain, pruritus, and jaundice. Total bilirubin is 4.2 mg/dL, alkaline phosphatase is elevated, and ultrasound shows a dilated common bile duct with gallstones. Which of the following is the most appropriate next step?

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Correct answer: D — ERCP for suspected choledocholithiasis

Jaundice, cholestatic liver tests, common bile duct dilation, and gallstones suggest choledocholithiasis. ERCP is appropriate when probability is high, followed by cholecystectomy planning.

Reference: ASGE Choledocholithiasis Guideline