PAEA Surgery End Of Rotation (EOR) Practice Exam

What is a common differential diagnosis for jaundice?

1. Hematoma

2. Cholelithiasis

3. Gastritis

4. Diverticulitis

The correct answer is: Cholelithiasis

The presence of jaundice, characterized by the yellowing of the skin and eyes, is commonly due to an elevation of bilirubin levels in the blood. One of the leading causes of this elevation is related to biliary obstruction, which can occur due to cholelithiasis, or gallstones. These stones can obstruct the bile ducts, leading to an accumulation of bilirubin when it cannot be properly excreted into the intestine. Cholelithiasis is a relevant differential diagnosis for jaundice because the obstruction caused by gallstones can lead to both conjugated (direct) and unconjugated (indirect) hyperbilirubinemia depending on the site and extent of the blockage. This underlying mechanism makes it a direct connection to the presentation of jaundice, thereby serving as a common differential diagnosis in clinical practice. In contrast, the other options—hematoma, gastritis, and diverticulitis—do not have the direct relationship with the bile system and bilirubin metabolism that cholelithiasis does. While hematomas may cause jaundice in rare circumstances due to hemolysis associated with large hematomas, they are far less common. Gastritis primarily affects the stomach and does not have an impact on bilirubin levels or