This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous (Gall Bladder & Bile Ducts), Subject name: Surgery
"Limey bile" is? 
Select and explain. 
A. Present in the CBD, B. Thin and clear, C. Like toothpaste emulsion in the gall bladder, D. Bacteria rich
C: Like toothpaste emulsion in the gall bladder
Answer: C: Like toothpaste emulsion in the gall bladder 
Explanation: Ans. (c) Like toothpaste emulsion in the gall bladderRef: Harrison 18th ed/2622* It is a complication of chronic cholecystitis.* Calcium salts in the lumen of the gall bladder in sufficient concentration may produce calcium precipitation and diffuse, hazy opacification of bile or a layering effect on plain abdominal radiography.* This so called limey bile or milk of calcium bile, is usually clinically innocuous but cholecystectomy is recommended, especially when it occurs in a hydropic gall bladder.* In the entity called porcelain gall bladder, calcium salt deposition within the wall of a chronically inflamed gall bladder may be detected on the plain abdominal film.