RUQ is definitely first but this gets at the need to further evaluate the cholangitis and obstructive jaundice part I believe with more advanced imaging - cholangitis falls under the very strong predictor which puts it on the pre-op ERCP pathway in the amboss article flow chart
there’s no way you will need all or any of the extra stuff for step 2. strongly leaning towards reverting that… i’m not familiar with the guideline for this text change but the question does say diagnostic, does that influence anything @Alex
I agree, most likely not needed. I just added those extra details in case someone is curious how exactly the risk is assessed. Maybe move them to the Additional resources field? @ dollajas
Additional resources will behave differently in the near future - not opposed to moving it there. just also wary of resource overload especially when that information is not driven by a practice question or professional guideline. going to use my better judgement in this case - i think those details can be safely ignored (until uworld says so)
Understood👌
not sure what uworld says, but the article for cholangitis on amboss states “Abdominal ultrasound: to screen for mechanical bile obstruction -
Magnetic resonance cholangiopancreatography: to confirm intrahepatic bile duct occlusion” - cant really find a diagnostic chart for “obstructive jaundice” workup…card is probably good removing ERCP/MRCP, but maybe include “follow-up imaging with MRCP/ERCP may be necessary to confirm bile duct occlusion” in the extras
final edit based on diagnostics in https://next.amboss.com/us/article/Qq0uyS?q=ascending+cholangitis#Z9f187436aa934749f4437c12be5f3f0d