PAEA Surgery End Of Rotation (EOR) Practice Exam

What radiographic study is often used first to evaluate for gallstones?

1. CT scan

2. Ultrasound

3. X-ray

4. MRI

The correct answer is: Ultrasound

Ultrasound is the first-line radiographic study commonly used to evaluate for gallstones because it is non-invasive, readily available, and highly sensitive in detecting gallstones within the gallbladder. It utilizes sound waves to produce images of the organs and structures inside the abdomen without exposing the patient to ionizing radiation, making it especially suitable for a wide range of patients, including pregnant women and those with allergies or contraindications to contrast dye. Ultrasound can effectively identify both the presence of gallstones and other associated conditions such as gallbladder inflammation or complications like cholecystitis. It can also help visualize potential blockages in the bile duct caused by gallstones. The ability to perform the procedure at the bedside is an added convenience in emergency settings. Other modalities, while useful in certain circumstances, do not serve as the initial approach. For instance, a CT scan, while very effective for various abdominal pathologies, is often more costly and involves radiation exposure. X-rays have limited utility for detecting gallstones, as most stones are not radiopaque. MRI, although useful for specific conditions, such as assessing the biliary tree or looking for complications, is not typically the first choice for initial gallstone evaluation.