lala nbme2 - vbhalani

[ArchivalUser]

32. A previously healthy 67-year-old woman is admitted to the hospital because of a 2-week history of dark urine, clay-colored stools, and increasing jaundice. She has had a 9-kg (20-lb) weight loss over the past 2 months due to loss of appetite. She also has had generalized itching that is most severe at night. She has not had any abdominal pain. Examination shows no abnormalities except for jaundice. Which of the following is the most likely diagnosis?

A
) Common bile duct stone

B
) Drug-induced jaundice

*C
) Hemolytic jaundice

D
) Pancreatic carcinoma

E
) Viral hepatitis

[ArchivalUser]

dd

[ArchivalUser]

why is it D mimi?

my thinking was, its not D because "previously healthy" i.e. no history of gallstone, alcoholism.. and then she has not had any abdominal pain.. also, it is acute onset of these findings, more suggestive of hemolysis.. and i think that pruritis is caused by unconj bili?

i thought it was C

[ArchivalUser]

but how will u account for the weight loss?? pancr ca presents with painless jaundice n wt loss is since 2 months

[ArchivalUser]

elderly with painless jaundice ..first think of pancreatic carcinoma --uw ..