Practice targeted AMC-style multiple-choice questions on cholangitis.
A 72-year-old man with a history of cholelithiasis presents with a 2-day history of fever, jaundice, and severe right upper quadrant pain. His vital signs are stable, but laboratory tests show elevated bilirubin and alkaline phosphatase. He is undergoing urgent ERCP for management of suspected choledocholithiasis and cholangitis. Following successful cannulation and injection of contrast, the image is obtained. Considering the findings demonstrated in the image in the context of this patient's presentation, what is the most appropriate immediate next step during this procedure?
A 70-year-old male with ascending cholangitis undergoes ERCP. The image is obtained. What is the MOST appropriate next step in management?
A 58-year-old woman with cholangitis undergoes ERCP. The image is obtained. What intervention is MOST appropriate at this time?
A 72-year-old male with acute cholangitis is undergoing ERCP for stone extraction. The image is obtained after cannulation. Based on the findings, what is the most appropriate immediate next step in the procedure?
A 72-year-old presents with acute cholangitis (fever, jaundice, RUQ pain). LFTs show obstructive pattern. ERCP is performed for biliary decompression and stone extraction. Following successful cannulation and cholangiography, the image is obtained. Based on the findings demonstrated in the image, what is the most appropriate immediate next step during this procedure?
A 72-year-old male presents with fever, jaundice, and right upper quadrant pain. Investigations confirm acute cholangitis secondary to choledocholithiasis. He is taken for urgent ERCP. Following successful cannulation of the common bile duct and injection of contrast, the image is captured. Considering the findings visualised in the image, which of the following interventions is the most appropriate immediate next step to enable successful management of the underlying pathology during this procedure?
A 68-year-old woman presented to the emergency department with right upper quadrant abdominal pain, fever, and jaundice. Initial investigations showed a WCC of 14,000, total bilirubin 6.0, ALP 450, ALT 300. She was diagnosed with acute cholangitis and underwent urgent ERCP, during which the image was obtained. Following successful endoscopic stone extraction and significant clinical improvement with normalising inflammatory markers and liver function tests, what is the MOST appropriate next step in the long-term management of this patient's condition?
A 68-year-old woman presents to the emergency department with a 2-day history of right upper quadrant abdominal pain, fever, and yellowing of her eyes. Her vital signs are stable, but laboratory investigations reveal elevated inflammatory markers and liver function tests consistent with biliary obstruction and infection. An ERCP is performed, and the image is obtained. Following successful intervention to relieve the obstruction, the patient's symptoms begin to improve. Considering the likely underlying cause of this presentation and the findings during the procedure, what is the MOST appropriate next step in managing this patient's condition?