This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
All of the following are seen with bile duct stone except: March 2008 
Select and explain. 
A. Obstructive jaundice, B. Distended and palpable gall bladder, C. Pruritis, D. Clay coloured stools
B: Distended and palpable gall bladder
Answer: B: Distended and palpable gall bladder 
Explanation: Ans. B: Distended and palpable gall bladder Jaundice occurs when the CBD becomes obstructed and conjugated bilirubin enters the bloodstream. A history of clay-colored stools and tea-colored urine is obtained from such patients in approximately 50% of cases. The jaundice can be episodic. Palpable gallbladder (Courvoisier sign) may indicate gall bladder malignancy.