Phys Written Answers · gastrointestinal
Gallstone Disease AND Biliary Pathology — Written Clinical Reasoning
DCE-style written reasoning for Gallstone Disease AND Biliary Pathology.
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Target exams
SAQ 1 — Integrated plan (12 marks)
Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]
Model Answer
1. Frame and red flags (3 marks) [1]
State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]
2. Discriminating assessment (3 marks) [2]
List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]
3. Treatment sequence (4 marks) [1] [3]
Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]
4. Follow-up and communication (2 marks) [2]
Disposition, safety-net advice, and who owns follow-up. [1] [2]
References6ShowHide
- [1]Oyebamiji T, Schmitz R, Gebran A, Hendawy BS, et al. Focal Nodular Hyperplasia Presenting With Biliary Obstruction and Intrahepatic Gallstones: A Case Report and Literature Review Cureus, 2026.PMID 42388947
- [2]Golse N, Boulard P, Ciacio O, Robin F, et al. Gallstones: Physiopathology and treatment of cholelithiasis (part 1) J Visc Surg, 2026.PMID 42203606
- [3]Robin-Lersundi A, Abella Alvarez A, San Miguel Mendez C, Moreno Elalo-Olaso A, et al. Multidisciplinary Approach to Treating Severe Acute Pancreatitis in a Low-Volume Hospital World J Surg, 2019.PMID 31440777
- [4]Tazuma S, Nakanuma Y Clinical features of hepatolithiasis: analyses of multicenter-based surveys in Japan Lipids Health Dis, 2015.PMID 26475606
- [5]Chathadi KV, Chandrasekhara V, Acosta RD, et al. The role of ERCP in benign diseases of the biliary tract Gastrointest Endosc, 2015.PMID 25665931
- [8]Loozen CS, van Santvoort HC, van Duijvendijk P, et al. Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial BMJ, 2018.PMID 30297544