Pathology EMQ template.

Name: Jade Zhao

Theme: Liver and biliary disease

 

OPTION LIST

 

A	Alcoholic liver disease	I	Primary biliary cirrhosis
B	Alpha-1-antitrypsin deficiency	J	Primary sclerosing cholangitis
C	Gallstone	K
D	Gilbert’s syndrome	L
E	Hepatitis A	M
F	Hepatitis B	N
G	Hepatitis C	O
H	Hereditary haemochromatosis	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. A 40 year old school teacher with a past medical history of ulcerative colitis presents to A&E complaining of abdominal pain, itching and yellowing of the skin. His blood tests reveal elevated ALP, elevated bilirubin and hypergammaglobinaemia

 

 

2. A 23 year old man presents to his GP with fever and purulent sputum of one week in duration. On a routine blood test he is found to have an elevated serum bilirubin but all other liver function tests were normal.

 

 

3. A 50 year old man presents to his GP complaining of tiredness and has recently noticed some skin discolouration. Examination reveals clubbing of the fingers, spider naevi on the chest and hepatomegaly. His blood tests reveal elevated serum ferritin, elevated serum iron and elevated blood glucose.

 

 

4. A 20 year medical student returns from her holiday in Cambodia with fever, malaise and arthralgia. Examination reveals hepatomegaly and jaundice. Blood tests reveal elevated AST and ALT. She spontaneously recovers after 3 weeks.

 

 

5. A 49 year old female complains of tiredness and itchy skin. Her GP performs some routine blood tests which show elevated ALP and γGT. She was later found to be positive for anti-mitochondrial antibodies.

 

 

 

ANSWERS

1. J

2. D

3. H

4. E

5. I