A 62-year-old woman presents as triage level 2 with fever, jaundice, and right upper quadrant pain. BP is 92/58 mm Hg, bilirubin is 5.4 mg/dL,

Question

A 62-year-old woman presents as triage level 2 with fever, jaundice, and right upper quadrant pain. BP is 92/58 mm Hg, bilirubin is 5.4 mg/dL, lactate is 3.2 mmol/L, and ultrasound shows a dilated common bile duct. Which of the following is the most appropriate next step in management?

Accepted Answer

IV broad-spectrum antibiotics and urgent biliary decompression

Answer

High-dose steroids for autoimmune hepatitis

Answer

Immediate colonoscopy

Answer

Discharge with outpatient cholecystectomy referral

Answer

Oral ursodiol and dietary advice

Acute ascending cholangitis — ABEM Board MCQ

A 62-year-old woman presents as triage level 2 with fever, jaundice, and right upper quadrant pain. BP is 92/58 mm Hg, bilirubin is 5.4 mg/dL, lactate is 3.2 mmol/L, and ultrasound shows a dilated common bile duct. Which of the following is the most appropriate next step in management?