Pathology EMQ template.

Name: Jen Mae Low

Theme: Liver and Biliary Disease

OPTION LIST

A	Ascending cholangitis	I	Primary biliary cirrhosis
B	Carcinoma of the head of the pancreas	J	Primary sclerosing cholangitis
C	Cholangiocarcinoma	K	Wilson’s disease
D	Common bile duct stone	L
E	Dubin-Johnson syndrome	M
F	Gilbert’s syndrome	N
G	Haemolytic jaundice	O
H	Pancreatitis	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. 25 year old man presents with jaundice, fever, and right upper quadrant pain.

2. 25 year old man presents with a 3 year history of occasional episodes of mild jaundice that worsened during a chest infection. He has mild unconjugated hyperbilirubinaemia with a normal liver biopsy.

3. 45 year old lady presents with mildly elevated serum bilirubin, normal alkaline phosphatase and AST, and anaemia. No urinary bilirubin present.

4. 28 year old man presents with mildly elevated serum bilirubin, normal alkaline phosphatase and AST, and normal haemoglobin. No urinary bilirubin present.

5. 32 year old lady with a history of inflammatory bowel disease presents with intermittent jaundice, itching, weight loss, and pain in the right hypochondrium. Alkaline phosphatase levels are raised.

ANSWERS

1. A

2. F

3. G

4. F

5. J