A 75-year-old man presents to the emergency department when his primary care physician ordered laboratory testing after he was noted to have scleral icterus and jaundice. The patients total bilirubin level is 5.2 mg/dL and his alkaline phosphatase level is 327 U/L. He has had low-grade abdominal pain over the past few days but attributed it to his chronic irritable bowel syndrome. He has had no prior surgeries and reports he is otherwise healthy. He takes a statin for high cholesterol. His vital signs on presentation are temperature 101.5oF, heart rate 98 beats per minute, and blood pressure 115/86 mm Hg. Which of the following is the appropriate imaging test to order for this patient?

BILIARY

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Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]

A 75-year-old man presents to the emergency department when his primary care physician ordered laboratory testing after he was noted to have scleral icterus and jaundice. The patient’s total bilirubin level is 5.2 mg/dL and his alkaline phosphatase level is 327 U/L. He has had low-grade abdominal pain over the past few days but attributed it to his chronic irritable bowel syndrome. He has had no prior surgeries and reports he is otherwise healthy. He takes a statin for high cholesterol. His vital signs on presentation are temperature 101.5oF, heart rate 98 beats per minute, and blood pressure 115/86 mm Hg. Which of the following is the appropriate imaging test to order for this patient?

A	Abdominal ultrasound
B	Abdominal computed tomography (CT)
C	Magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP)
D	Hepatobiliary iminodiacetic acid (HIDA) scan

Explanation:

Detailed explanation-1: -The liver helps break down bilirubin so that it can be removed from the body in the stool. A level of bilirubin in the blood of 2.0 mg/dL can create jaundice. Jaundice is a yellow color in the skin, mucus membranes, or eyes.

Detailed explanation-2: -Serum Bilirubin Bilirubin values of 2.5–3.0 mg/dl or greater establish the presence of the icteric phase of hepatitis.

Detailed explanation-3: -Bilirubin passes through the liver and is eventually excreted out of the body. Higher than usual levels of bilirubin may indicate different types of liver or bile duct problems. Sometimes, higher bilirubin levels may be caused by an increased rate of destruction of red blood cells.

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PATHOLOGY

PATHOLOGY MCQ

BILIARY