Pancreas: practice question

A General Surgery 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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General Surgery · Pancreas

Sample item

A 66-year-old man has progressive painless jaundice, weight loss and a palpable, non-tender gallbladder. What is the most likely diagnosis?

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

The answer and the reasoning

A. Carcinoma of the head of the pancreas

Courvoisier's law states that a palpable, non-tender gallbladder with jaundice is unlikely to be due to stones. Chronic stone disease leaves a fibrosed, contracted gallbladder that cannot distend. Malignant obstruction, as in a pancreatic head tumour, distends a healthy gallbladder.

Option by option

  • A. Carcinoma of the head of the pancreas (correct)

    Correct. A distal malignant obstruction produces painless jaundice and gallbladder distension.

  • B. Chronic calculous cholecystitis

    Chronic cholecystitis leaves a shrunken gallbladder and rarely causes jaundice.

  • C. Acute viral hepatitis

    Hepatitis does not obstruct the bile duct and would not distend the gallbladder.

  • D. Gallstone obstruction of the common bile duct

    Stones typically cause pain, and the scarred gallbladder does not distend.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Carcinoma of the head of the pancreas. Courvoisier's law states that a palpable, non-tender gallbladder with jaundice is unlikely to be due to stones.

Why is "Chronic calculous cholecystitis" not the answer?

Chronic cholecystitis leaves a shrunken gallbladder and rarely causes jaundice.

Why is "Acute viral hepatitis" not the answer?

Hepatitis does not obstruct the bile duct and would not distend the gallbladder.

Why is "Gallstone obstruction of the common bile duct" not the answer?

Stones typically cause pain, and the scarred gallbladder does not distend.

What concept does this question test?

It tests Pancreas in General Surgery. Chronic stone disease leaves a fibrosed, contracted gallbladder that cannot distend. Malignant obstruction, as in a pancreatic head tumour, distends a healthy gallbladder.

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 Pancreas?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.