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48. In enterohepatic circulation of bilirubin, most bile salts are reabsorbed in the:

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3 MCQs from this picture and triad In one exam

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Mnemonic: Charcot’s triad screams cholangitis louder than a restaurant alarm.

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47. A patient with fever, jaundice, and right upper quadrant pain presents with Charcot’s triad. The diagnosis is:

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Mnemonic: Big, firm gallbladder? Pancreatic cancer is the sneaky guest.

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46. A 60-year-old male presents with jaundice, weight loss, and palpable gallbladder (Courvoisier's sign). The most likely diagnosis is:

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Mnemonic: For a grumpy gallbladder, ultrasound is like a detective with X-ray vision.

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45. The most sensitive and specific investigation for acute cholecystitis is:

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Mnemonic: Saint’s triad doesn’t touch the esophagus, achalasia stays home.

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44. Saint’s triad includes all of the following EXCEPT:

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Mnemonic: Gallstones hide, they’re mostly invisible on X-ray!. If you want to see the sneaky stones hiding, trust the ultra-sound spy instead of X-rays!

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43. Regarding gallstones, all are true EXCEPT:

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Crohn says: cut out the diseased bowel and I’m gone, temporary peace, not forever.

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42. Which of the following is true about Crohn's disease?

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Mnemonic: Bright red blood on the paper? Thank hemorrhoids, the pesky red painters of the rectum!

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41. The most probable cause of bright red bleeding per rectum is:

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Mnemonic: Pylorus blocked? Your stomach acts like a grumpy old chemist—alkaline, low K & Cl, never acidic.

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40. Chronic pyloric obstruction produces all of the following EXCEPT:

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Other Possible Symptoms 🤢💨 Nausea / bloating Belching Occult GI bleeding → dark/tarry stools Mnemonic: “NBB: Nausea, Belching, Bleeding” Complications Warning Signs 🚨 Perforation: sudden severe pain, rigid abdomen ⚡💥 Bleeding: hematemesis (vomiting blood) 🤮🩸

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Pain Timing: Hunger → Food Relieves 🍽️🔥→❄️ Pain occurs when stomach is empty Eating or milk can temporarily soothe it