Not true of bile stone formation is

A. Brown pigment stones are more commonly seen in the bile duct than gallbladder
B. Patients with cirrhosis have a higher instance of pigmented stones
C. Black stones are associated with hereditary spherocytosis
D. Ascaris lumbricoides infection is associated with cholesterol stones

All are true regarding imaging of gallbladder except

A. HIDA scan has a sensitivity of up to 97% for the diagnosis of acute cholecystitis
B. Common bile duct (CBD) measurements more than 4mm suggest choledocholithiasis in young people
C. CT imaging of the abdomen adds to sensitivity or specificity of USG diagnosis of cholelithiasis
D. Magnetic retrograde cholangiopancreatography (ERCP/MRCP) is useful in suspected cholangitis

Prophylactic cholecystectomy in cholelithiasis may be considered for all except

A. Porcelain gallbladder
B. Congenital haemolytic anemia
C. Patients undergoing bariatric surgery for morbid obesity
D. Large asymptomatic gallstones

All are risk factors for cholelithiasis except

A. Rapid weight loss
B. Antibiotic ceftriaxone therapy
C. Decreased biliary secretory Immunoglobulin G
D. Low activity of cholesterol 7α hydroxylase

Therapy with bile salts is not suitable for

A. Patients with poor risks for surgery
B. Stones in the common bile duct
C. Noncalcified cholesterol gallstones
D. Chronic cholecystitis

In short

A positive Murphy’s sign suggests acute inflammation of gallbladder and may be associated with a leukocytosis and moderately elevated liver function tests.

Charcot’s triad consists of severe RUQ tenderness with fever and jaundice and is classic for cholangitis.

A palpable, non-tender gallbladder (Courvoisier’s sign) usually results from a
distal common duct obstruction secondary to a peripancreatic malignancy.

Tenderness when the hand taps the right costal arch is known as Ortner’s sign.

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