American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary condition identified by biliary pain associated with dilated bile ducts on ultrasound?

1. Cholecystitis

2. Choledocholithiasis

3. Pancreatitis

4. Biliary atresia

The correct answer is: Choledocholithiasis

The primary condition characterized by biliary pain alongside dilated bile ducts on ultrasound is choledocholithiasis. This condition refers to the presence of gallstones within the common bile duct, which can block the flow of bile. The obstruction can lead to elevated pressure within the bile duct system, resulting in pain and the potential for further complications such as cholangitis or pancreatitis. Ultrasound is a valuable imaging modality in this context because it can effectively visualize the dilated bile ducts, which are indicative of an obstructive process. In cases of choledocholithiasis, the presence of stones can often be confirmed, and the associated biliary pain aligns with the expected clinical presentation of this condition. Other conditions such as cholecystitis, pancreatitis, and biliary atresia do not primarily present with the unique combination of symptoms specific to choledocholithiasis. Cholecystitis typically involves inflammation of the gallbladder rather than the bile duct. Pancreatitis is inflammation of the pancreas and may have overlapping symptoms, but it is not directly linked with the findings of dilated bile ducts alone. Biliary atresia is a congenital condition that leads to biliary obstruction but presents differently in terms of age