USMLE Step 2 Quiz
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GASTROENTEROLOGY
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A 56-year-old woman presents with right upper quadrant pain and jaundice. Laboratory studies show total bilirubin 4.5 mg/dL, direct bilirubin 3.2 mg/dL, AST 250 U/L, ALT 300 U/L, and alkaline phosphatase 500 U/L. An ultrasound reveals gallstones and a common bile duct diameter of 10 mm. A stone is suspected but not definitively seen in the distal duct.
Which of the following is the best next step in both diagnosis and management?
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