"Gallstones" isn't a diagnosis — it's a finding. The same word can mean a patient who goes home with a clinic number or one who needs an ERCP tonight. This attending's guide maps biliary disease as one road system blocked at different points: biliary colic, cholecystitis, choledocholithiasis, cholangitis, and gallstone pancreatitis. Learn to ask where the stone is sitting — because the address, not the word, is the diagnosis.

Appendicitis isn't a hard diagnosis — it's the one trainees talk themselves out of when a normal white count outvotes a textbook story. An attending walks through the workup that actually decides it: the symptom sequence, the exam that confirms rather than discovers, the pregnancy test that comes before the scanner, and the atypical appendixes that come back to find you.