Clinical Decision-Making (CDM) Cases Part I Practice Test 2026 - Free CDM Practice Questions and Study Guide

In biliary colic when choledocholithiasis is suspected, the priority is to detect obstruction and cholestasis. A liver function test panel that includes AST, ALT, alkaline phosphatase, GGT, and bilirubin is most informative because obstruction of the bile duct tends to cause a cholestatic pattern: alkaline phosphatase and GGT rise, and bilirubin (often direct/conjugated) increases when bile flow is blocked. AST and ALT may also be modestly elevated with biliary obstruction. This pattern helps identify a ductal blockage rather than a primary hepatocellular injury. A CBC is less specific for choledocholithiasis, and lipase or amylase are used when pancreatitis is suspected, not as routine tests for this condition.