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
Lithogenic bile has the following properties - 
Select and explain. 
A. ↑ Bile and cholesterol ratio, B. ↓Bile and cholesterol ratio, C. Equal bile and cholesterol ratio, D. ↓Cholesterol only
B: ↓Bile and cholesterol ratio
Answer: B: ↓Bile and cholesterol ratio 
Explanation: Bile salts and phospholipids in bile keep cholesterol in solution by the formation of micelles.
An excess of cholesterol relative to bile salts and phospholipids allows cholesterol to form crystals and such pile is called Lithogenic or super-saturated bile.

Pathogenesis of Cholesterol gallstones 

There are three elements necessary for the formation of cholesterol gallstones


Lithogenic bile
Nucleation and
Stasis or gallbladder hypomotility