A 54-year-old woman presented with fatigue and dark urine for 8 weeks. On physical examination, she has positive scleral icterus. Initial investigations showed: Alanine aminotransferase 78 U/L (10 – 40) Aspartate aminotransferase 88 U/L (10 – 30) Serum bilirubin 20.8 mg /dL (0.3 – 1.2) Direct bilirubin 12.0 mg/dL (0 – 0.2) Alkaline phosphatase 145 U/L (25 – 100) Serum albumin 3.1 g/dL (3.4 – 4.8) Serum protein 8.7 g/dL (6.4 – 8.3) Prothrombin time 18 sec (18 – 22 ) Which of the following tests should be performed next ?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Abdominal ultrasound
She has jaundice with a predominantly conjugated hyperbilirubinemia and raised ALP, so the next step is to look for biliary obstruction (dilated ducts) with abdominal ultrasound - the standard first imaging test in every jaundiced patient.
- ERCP is invasive and reserved for confirmation/treatment once obstruction is likely.
- CT/MRCP are second-line if ultrasound is inconclusive; cirrhosis blood work comes after obstruction is excluded.
- المصدر
- Jaundice (1).pdf · p. 3
gallbladder - Afnan.pdf · p. 17 - المحاضرة
- Gallbladder Conditions · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 86 Q70