Name: Sharif Ismail

Theme: liver and biliary disease

 

OPTION LIST

 

A	Hepatitis A infection	I	IFN-alpha + ribavirin
B	Hepatitis B infection	J	Prednisolone
C	Hepatitis C infection	K	Colestyramine
D	Ascending cholangitis	L	Penicillamine
E	Wilson’s disease	M	Ursodeoxycholic acid
F	Primary sclerosing cholangitis	N	Venesection
G	Primary biliary cirrhosis	O	Liver transplant
H	Chronic alcohol abuse	P	Supportive

 

 

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 52 year-old woman with long-standing (but now worsening) pruritus and anergia. Bloods demonstrate very raised alk phos and moderately raised bilirubin. Liver biopsy shows granuloma formation around the bile ducts. What is the diagnosis?

 

2. A 27 year-old Egyptian health worker presents with prodromal symptoms and signs of jaundice. Bloods show AST 430, ALT 500, alk phos 160, and both HBsAg and HBeAg are present. What is your management?

 

3. A 63 year-old man complains of right hypochondrial pain and tiredness. Following blood results a liver biopsy is taken which shows heavy haemosiderin deposition. What is your management?

 

4. A 44 year-old man with signs of cirrhosis undergoes a liver biopsy which shows neutrophilic infiltration and Mallory hyaline in addition to cirrhotic damage. What is the diagnosis?

 

5. A teenager with tremor, depression and signs of liver disease. Liver biopsy shows raised liver copper content. What is the diagnosis?

 

 

 

ANSWERS

1. G

2. P

3. N

4. H

5. E