Biliary imaging: primary sclerosing cholangitis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Biliary imaging: primary sclerosing cholangitis

Sample item

A young man with ulcerative colitis has a cholestatic liver profile. Which investigation best demonstrates the likely bile duct abnormality without invasive risk?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. MRCP showing multifocal strictures and dilatations of intra- and extrahepatic ducts

Primary sclerosing cholangitis is associated with ulcerative colitis and gives a beaded appearance from alternating strictures and dilatations. MRCP is non-invasive and avoids the pancreatitis risk of ERCP. Cholangiocarcinoma is a recognised complication.

Option by option

  • A. HIDA scan for ductal anatomy

    A HIDA scan shows bile flow rather than detailed ductal anatomy.

  • B. Oral cholecystography

    Oral cholecystography is obsolete and does not show the ducts well.

  • C. Plain abdominal film

    A plain film cannot show the bile ducts.

  • D. MRCP showing multifocal strictures and dilatations of intra- and extrahepatic ducts (correct)

    Correct. MRCP shows the beaded duct pattern non-invasively.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, MRCP showing multifocal strictures and dilatations of intra- and extrahepatic ducts. Primary sclerosing cholangitis is associated with ulcerative colitis and gives a beaded appearance from alternating strictures and dilatations.

Why is "HIDA scan for ductal anatomy" not the answer?

A HIDA scan shows bile flow rather than detailed ductal anatomy.

Why is "Oral cholecystography" not the answer?

Oral cholecystography is obsolete and does not show the ducts well.

Why is "Plain abdominal film" not the answer?

A plain film cannot show the bile ducts.

What concept does this question test?

It tests Biliary imaging: primary sclerosing cholangitis in Radiology. MRCP is non-invasive and avoids the pancreatitis risk of ERCP. Cholangiocarcinoma is a recognised complication.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Biliary imaging: primary sclerosing cholangitis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.