HY USMLE Q #640 – Gastro

A 50-year-old man with well-controlled type II diabetes mellitus comes to the emergency department 24 hours after the onset of abdominal pain. Temperature is 102 F. Examination shows scleral icterus. Laboratory studies show:

WBC                                                                     16,000/μL
Glucose                                                               600 mg/dL
Total bilirubin                                                  5.0 mg/dL
Direct bilirubin                                               2.0 mg/dL
ALP                                                                        320 IU/dL
Amylase                                                              100 IU/L

Which of the following is the most likely diagnosis?

Biliary cirrhosis
Cholangitis
Cholecystitis
Hepatitis
Pancreatitis (acute on chronic)