Pathology EMQ template.

Name:

Theme: Liver diseases

 

OPTION LIST

 

A	Ascending cholangitis	I	Non-alcoholic steatohepatitis
B	Primary biliary sclerosis	J	Wilson’s
C	Hemochromatosis	K
D	Alcoholic hepatitis	L
E	Alpha 1 Antitripsin deficiency	M
F	Viral hepatitis	N
G	Primary sclerosing cholangitis	O
H	Drug induced hepatitis.	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.

 

1. Patient presented with jaundice. He told you that he is previously diagnosed with ulcerative colitis. Liver function test are as follows: AST=285, ALT=278, Alk Phos=517. What’s the most likely diagnosis?

 

2. Patient was admitted with fever and malaise. Liver function test are as follows: AST=314, ALT=281, Alk Phos=276. Liver biopsy showed ballooning of the hepatocytes with Mallory bodies, what’s the most likely diagnosis.

 

3. Liver biopsy in a cirrhotic patient revealed Periodic Acid Shiff stain (PAS) positive, diastase resistant granules in the cells. What’s the most likely diagnosis?

 

4. 47 year old diabetic patient presented with severe fatigue and arthralgia. Blood test showed abnormal liver enzymes. Liver biopsy was conducted and found fibrosis and abnormal pigmentation, which was stained by Prussian blue. What’s the diagnosis?

 

5. Patient presented with fever and malaise. Liver function was deranged and biopsy showed diffuse necrotic changes. HbsAg was positive.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS

1. G

2. D

3. E

4. C

5. F

 

 

2: AST:ALT ratio of greater than 1 is suggestive of alcoholic hepatitis, as AST is found in the mitochondria and ethanol is a mitochondrial poison. Mallory body is primarily associated with alcoholic hepatitis and is inclusions containing ubiquinated Keratin intermediate fillaments