Pathology EMQ template.

Name: Yizhou Wan

Candidate number: 1185

Theme: Liver and Biliary Disease

 

OPTION LIST

 

A	Serum alanine transminase (ALT)	I	Anti-smooth muscle Ab
B	Serum aspartate transaminase (AST)	J	Anti-mitochondria Ab
C	Serum gamma-glutamyltransferase (GGT)	K	Anti- nuclear Ab
D	Urine urobilinogen	L	Alpha-fetoprotein (AFP)
E	Serum albumin	M	Conjugated bilirubin < 20%
F	Blood Urea Nitrogen	N	Conjugated bilirubin > 50%
G	Serum Ammonia	O	Serum alkaline phosphatise
H	Serum IgM	P	Prothrombin time (PT)

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 40 year old man presents with a long history epigastric pain radiating to his back, often worse at night. He says he has a meeting to attend the next morning and would like to leave as soon as possible.

 

 

2. A 50 year old man presents with a long history of nausea and vomiting. He claims it was precipitated after taking paracetamol for a headache. Examination reveals deep jaundice and tender hepatomegaly. An arterial bruit is heard over the liver.

 

 

3. A 30 year old woman presents with jaundice and a history of easy bruising. She is otherwise well, examination reveals splenomegaly and hirsutism.

 

 

4. A 40 year old woman presents with jaundice, pruritus and fatigue. She has a history of ulcerative colitis. ERCP demonstrates that the intrahepatic and extrahepatic bile ducts have a beaded appearance.

 

5. A 24 year old woman presents with vomiting and lower abdominal pain radiating to her back. She is 32 weeks pregnant and has so far had an uncomplicated pregnancy. The obstetrics assessment is normal.

 

 

 

ANSWERS

1. F

2. B

3. J

4. K

5. C