Archive Of Standardized Exam Questions: Ascending Cholangitis


This page is dedicated to organizing various examples of standardized exam questions whose answer is ascending cholangitis. While this may seem a odd practice, it is useful to see multiple examples of how ascending cholangitis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.


Question # 1

A 55 year old woman with type 2 diabetes comes to the emergency department after the onset of abdominal pain. Since coming to the ER the patient has already vomited twice and appears toxic. Her BMI is 37 kg/m2, temperature is 102.9°F, pulse is 120/min, respirations are 25/min, and blood pressure is 165/90 mm Hg. A physical exam reveals the presence of scleral icterus. The abdomen is slightly tender and otherwise unremarkable. Laboratory studies are reported below:

  • Hemoglobin: 12.7 g/dL
  • Leukocyte count: 18,000/mm3
  • Na+: 130 mEq/L
  • Cl-: 95 mEq/L
  • K+: 4.9 mEq/L
  • Bicarbonate: 15 mEq/L
  • Glucose: 586 mg/dL
  • Total bilirubin: 5.4 mg/dL
  • Direct bilirubin: 2.2 mg/dL
  • Alkaline phosphatase: 355 U/L
  • AST: 302 U/L
  • Amylase: 96 U/L

What is a possible diagnosis in this patient?



Page Updated: 01.22.2017