tess
Forum Guru
Topics: 131
Posts: 368
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A 60y woman comes to physician boz of jaudice, pruritis, and anorexia for 2 weeks. Cigatrees one pack a day for 30y. have thaizide for HTN. Icteric disocolationa of skin and mucosae. Slight tenderness and 1cm below costal arch liver. The spleen is not palpable. AST 60 U/L, ALT 40 U/L, ALP 1000 U/L, total bilirubin 5.5 mg/dl; direct bilirubin 4.0 mg/dl. Which of the following is the most appropriate next step in diagnosis?
a. Abdominal ultrasound
b. Abdominal CT or MRI scan
c. Endoscopic retrograde cholangiopancreatography
d. Percutaneous liver biopsy
e. Percutaneous transhepatic chlagniography
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| doc4mindia
Forum Guru
Topics: 134
Posts: 243
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c. Endoscopic retrograde cholangiopancreatography
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| tess
Forum Guru
Topics: 131
Posts: 368
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not this one, wanna try ? 8)
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| usmleasr
Forum Guru
Topics: 105
Posts: 970
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abdominal CT or MRI i think..
becos smoker and conjugated hyperbilurubinemia points to ca pancreas..
so CT or MRI is the best
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| doc_17
Forum Newbie
Topics: 3
Posts: 14
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i think we should go with ultrasound first,bec from Q we can make out tht its obstructive jaundice & should proceed to CT or MRI after tht.
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| tess
Forum Guru
Topics: 131
Posts: 368
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doc17! 
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