12 Hours Of Steady in Medicine / Internal Medicine — 38yo Man | Gastroenterology | SMLE Q#18455

SMLE Question #18455

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-CHOLEDOCHOLITH-1

Last updated: February 2026
A 38-year-old man presents with 12 hours of steady right upper quadrant/epigastric pain and nausea. Examination shows right upper quadrant tenderness without guarding and no scleral icterus. Abdominal ultrasound shows multiple gallbladder stones with normal gallbladder wall thickness and no pericholecystic fluid; the common bile duct is dilated. What is the most likely diagnosis?

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