Pathology EMQ template.

Name: A Jessel

Theme: LFT’s and Jaundice

 

OPTION LIST

 

A	Common Bile Duct stone	I	Alcoholic hepatitis
B	Budd-Chiari Syndrome	J	Primary biliary cirrhosis
C	Acute Viral Hepatitis	K
D	Gilbert’s Disease	L
E	Carcinoma head of pancreas	M
F	Auto immune hepatitis	N
G	Drug cholestasis	O
H	Secondary liver deposits	P

 

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. The following patients all have a mild jaundice.

 

1. A 72-year old woman complains of pruritis, anorexia and weight loss of 6kg. She denies significant abdominal pain. On physical examination there is a mass palpable in the right upper quadrant

 

2. A 26-year old lifeguard attends his GP with a 48-hour history of influenza-like symptoms. He has not eaten much recently and physical examination is normal. His GP noticed mild jaundice. His liver function tests are otherwise normal.

 

3. An 83-year old retired teacher complains of right upper quadrant abdominal pain, fever and rigors. She is tender in the right upper quadrant but no mass is palpable. Serum alkaline phosphatase is 955U/L, AST 83U/L and ALT 67U/L

 

4. A 40-year old female nurse presents with anorexia, nausea and mild jaundice. She has a liver edge two fingers palpable and slight ankle oedema. Her serum transaminases are elevated AST 610U/L, ALT 782U/L, IgG was 35g/L and anti HBs positive. Prothrombin time is prolonged to 18 seconds. Her liver function test had been recorded as mildly abnormal 3 months ago

 

5. A 56-year old chief executive with a previous history of lung resection for carcinoma of the bronchus, presents with weight loss, upper abdominal pain and 2cm enlarged liver. His alkaline alkaline phosphatase is 690U/L, the AST 51U/L and ALT 55U/L

 

ANSWERS

1.  H

2. D

3. A

4. C

5. H