Gallbladder and Biliary Tract Khristine Joy M. Calimlim-Carreon, MD

Case 1

Diagnosis A.Choledochal cyst type 1 B.Choledochal cyst type 2 C.Choledochal cyst type 3 D.Choledochal cyst type 4

Diagnosis A.Choledochal cyst type 1 B.Choledochal cyst type 2 C.Choledochal cyst type 3 D.Choledochal cyst type 4 P 1263

Characteristic A.Dilatation of the extrahepatic duct involving the common bile duct but may extend to the common hepatic duct B.Diverticulum of the extrahepatic bile duct C.Localized cystic dilatation of the distal, intramural duodenal portion of thr common bile duct D.Multiple cysts involving the intrahepatic and extrahepatic bile ducts

Characteristic A.Dilatation of the extrahepatic duct involving the common bile duct but may extend to the common hepatic duct B.Diverticulum of the extrahepatic bile duct C.Localized cystic dilatation of the distal, intramural duodenal portion of the common bile duct D.Multiple cysts involving the intrahepatic and extrahepatic bile ducts P 1263

Most precise way to confirm diagnosis A.Ultrasound B.CT scan C.Cholangiography D.MRI

Most precise way to confirm diagnosis A.Ultrasound B.CT scan C.Cholangiography D.MRI P 1266

What is single or multiple invovlement of the intrahepatic duct A.Choledochal cyst type 4A B.Choledochal cyst type 4B C.Caroli's disease D.Choledochocele

What is single or multiple invovlement of the intrahepatic duct A.Choledochal cyst type 4A B.Choledochal cyst type 4B C.Caroli's disease D.Choledochocele P 1263

Case 2

Diagnosis A.Gallbladder stone B.Cholesterol polyp C.Cholecystitis D.Bile sludge

Diagnosis A.Gallbladder stone B.Cholesterol polyp C.Cholecystitis D.Bile sludge P 1275

Sonographic finding: A.Hyperechoic focus with Posterior acoustic shadowing only B.Echogenic nonshadowing mural nodule C.Mural thickening of the gallbladder from subserosal edema D.Nonshadowing, Low to medium level echoes that layer in the dependent part of GB lumen

Sonographic finding: A.Hyperechoic focus with Posterior acoustic shadowing only B.Echogenic nonshadowing mural nodule C.Mural thickening of the gallbladder from subserosal edema D.Nonshadowing, Low to medium level echoes that layer in the dependent part of GB lumen P 1275

Complications of acute cholecystitis A.Gangrenous cholecystitis B.GB perforation & pericholecystic abscess C.Both A & B D.None of the above

Complications of acute cholecystitis A.Gangrenous cholecystitis B.GB perforation & pericholecystic abscess C.Both A & B D.None of the above P 1281 & 1285

Accuracy of imaging studies (ultrasound and cholescintigraphy) Exceed 70% Exceed 80% Exceed 90% Almost 100%

Accuracy of imaging studies (ultrasound and cholescintigraphy) Exceed 70% Exceed 80% Exceed 90% Almost 100% P 1279

Case 3

Diagnosis A.Hemorrhagic cholecystitis B.GB torsion C.Emphysematous cholecystitis D.Xanthogranulomatous cholecystitis

Diagnosis A.Hemorrhagic cholecystitis B.GB torsion C.Emphysematous cholecystitis D.Xanthogranulomatous cholecystitis P 1286

Organism most commonly associated A.Pseudomonas B.Klebsiella C.E.coli D.Staphylococcus

Organism most commonly associated A.Pseudomonas B.Klebsiella C.E.coli D.Staphylococcus P 1286

Sonograhic findings A.Intraluminal membranes, coarse intraluminal echoes, & focal mural irregularities B.Echogenic pericholecystic fluid collection C.Echogenic foci with reverberation artifacts or acoustic shadowing from the gallbladder lumen D.Marked distentiom of GB with course intraluminal echoes representing pus

Sonograhic findings A.Intraluminal membranes, coarse intraluminal echoes, & focal mural irregularities B.Echogenic pericholecystic fluid collection C.Echogenic foci with reverberation artifacts or acoustic shadowing from the gallbladder lumen D.Marked distentiom of GB with course intraluminal echoes representing pus P 1286

In what modality wherein there is difficulty in distinguishing intramural gas from porcelain GB with mural calcification? A.Plain abdominal radiograph B.CT scan C.Ultrasound D.None of the above

In what modality wherein there is difficulty in distinguishing intramural gas from porcelain GB with mural calcification? A.Plain abdominal radiograph B.CT scan C.Ultrasound D.None of the above P 1286

Case 4

Diagnosis A.Bronchobiliary fistula B.Choledochoduodenal fistula C.Choledocholonic fistula D.Choledochocutaneous fistula

Diagnosis A.Bronchobiliary fistula B.Choledochoduodenal fistula C.Choledocholonic fistula D.Choledochocutaneous fistula P 1317

Case 5

Diagnosis A.Hepatobiliary tuberculosis B.Primary sclerosing cholangitis C.Parasite within the biliary duct D.Bacterial cholangitis

Diagnosis A.Hepatobiliary tuberculosis B.Primary sclerosing cholangitis C.Parasite within the biliary duct D.Bacterial cholangitis P 1313

Sonographic findings A.Biliary stricture involving the porta hepatis level and less frequently the distal common bile duct B.Skip dilatation of the ducts C.Marked dilatation of the Common hepatic and common bile ducts that is filled with numerous parallel echogenic structures D.Marked thickening of the the duct wall in a concentric and diffuse distribution

Sonographic findings A.Biliary stricture involving the porta hepatis level and less frequently the distal common bile duct B.Skip dilatation of the ducts C.Marked dilatation of the Common hepatic and common bile ducts that is filled with numerous parallel echogenic structures D.Marked thickening of the the duct wall in a concentric and diffuse distribution P 1313

Most common parasite involve A.Ascaris lumbricoides B.Clonorchis sinensus C.Both A & B D.None of the above

Most common parasite involve A.Ascaris lumbricoides B.Clonorchis sinensus C.Both A & B D.None of the above P 1312