Professional and Linguistic Assessments Board (PLAB) Practice Exam

In which scenario should ERCP be performed?

1. If the patient is asymptomatic

2. If the patient is still jaundiced with stones in CBD

3. If the patient has abdominal pain only

4. After gallbladder removal surgery

The correct answer is: If the patient is still jaundiced with stones in CBD

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure used to diagnose and treat conditions related to the bile ducts and pancreatic ducts. The scenario in which ERCP should be performed is when a patient is still jaundiced with stones in the common bile duct (CBD). When a patient presents with jaundice, it indicates that there may be an obstruction or blockage in the biliary system, often due to the presence of gallstones. If stones are identified in the CBD and the patient is experiencing jaundice, ERCP can be crucial as it allows for both visualization of the ducts and the ability to remove these stones. This alleviation of the obstruction can improve liver function and resolve jaundice, thus addressing a potentially serious condition which could lead to complications such as cholangitis or pancreatitis. In contrast, performing ERCP on an asymptomatic patient or someone solely experiencing abdominal pain may not be appropriate, as these do not inherently indicate the need for intervention regarding the biliary system. Furthermore, performing ERCP after gallbladder removal (cholecystectomy) might be warranted if there are complications or persistent issues; however, the indication for the procedure would primarily relate to the current presence of obstruction due to