American Board of Internal Medicine (ABIM) Certification Practice Exam

Which symptom is NOT commonly associated with biliary colic?

1. Severe abdominal pain

2. Nausea

3. Jaundice

4. Vomiting

The correct answer is: Jaundice

Biliary colic is typically characterized by episodes of severe abdominal pain that often occurs due to the obstruction of the bile duct, usually caused by a gallstone. This colicky pain is often described as intense, located in the upper right quadrant of the abdomen, and can radiate to the back or right shoulder. Nausea and vomiting are common accompanying symptoms of biliary colic, as the intense pain can stimulate the autonomic nervous system, leading to gastrointestinal distress. A person experiencing biliary colic may often feel nauseous and may vomit due to the pain. Jaundice, on the other hand, is generally not a symptom associated with biliary colic. Jaundice occurs when there is an accumulation of bilirubin in the bloodstream, which happens when there is a blockage in the biliary system that prevents bile from properly draining. While jaundice could occur if there is a complication like acute cholecystitis or choledocholithiasis, it is not a common symptom that presents during an episode of biliary colic itself. Therefore, recognizing that jaundice is not typical for biliary colic helps clarify the nature of the symptoms directly related to this condition.