Abdominal and GI imaging: biliary atresia: 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 · Abdominal and GI imaging: biliary atresia

Sample item

A 6-week-old jaundiced infant has pale stools and conjugated hyperbilirubinaemia. Fasting ultrasound shows a small, poorly visible gallbladder and an echogenic fibrous band anterior to the right portal vein. Which diagnosis is most likely?

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

The answer and the reasoning

B. Biliary atresia

Biliary atresia presents with conjugated jaundice and acholic stools, and ultrasound shows an abnormal gallbladder with a triangular echogenic fibrous cord at the porta hepatis. Early diagnosis matters because a Kasai portoenterostomy works best before about 8 weeks. Neonatal hepatitis has a normal gallbladder.

Option by option

  • A. Neonatal hepatitis

    Neonatal hepatitis usually shows a normal or contractile gallbladder with no cord.

  • B. Biliary atresia (correct)

    Correct. A fibrous cord with a small gallbladder indicates biliary atresia.

  • C. Choledochal cyst

    A choledochal cyst appears as a cystic dilatation of the bile duct.

  • D. Physiological jaundice

    Physiological jaundice is unconjugated and appears around the second to third day.

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 B, Biliary atresia. Biliary atresia presents with conjugated jaundice and acholic stools, and ultrasound shows an abnormal gallbladder with a triangular echogenic fibrous cord at the porta hepatis.

Why is "Neonatal hepatitis" not the answer?

Neonatal hepatitis usually shows a normal or contractile gallbladder with no cord.

Why is "Choledochal cyst" not the answer?

A choledochal cyst appears as a cystic dilatation of the bile duct.

Why is "Physiological jaundice" not the answer?

Physiological jaundice is unconjugated and appears around the second to third day.

What concept does this question test?

It tests Abdominal and GI imaging: biliary atresia in Radiology. Early diagnosis matters because a Kasai portoenterostomy works best before about 8 weeks. Neonatal hepatitis has a normal 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 Abdominal and GI imaging: biliary atresia?

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.