Pathology EMQ template.

Name: Adam Marcus

Theme: Liver Disease

OPTION LIST

A	Acute cholecystitis	I	Gilbert’s syndrome
B	Alpha-1-antitrypsin deficiency	J	Haemochromatosis
C	Ascending cholangitis	K	Lucey-Driscoll syndrome
D	Autoimmune hepatitis	L	Primary biliary cirrhosis
E	Biliary colic	M	Rotor syndrome
F	Chronic cholecystitis	N	Sclerosing cholangitis
G	Crigler-Najjar syndrome	O	Viral hepatitis
H	Dubin-Johnson syndrome	P	Wilson’s disease

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. 24 year old male student returned from a backpacking holiday in India and presents with a several day history of fever, abdominal discomfort and dark urine. On examination his sclera is icteric and there is tender hepatomegaly.

2. 34 year old man with a known history of ulcerative colitis presents with a 2-week history of fever, itching and yellow discolouration of his skin. Abdominal ultrasound showed dilated intrahepatic ducts, the common bile duct was normal.

3. 47 year old man recently diagnosed with diabetes recently presents with with fatigue and persistent aching joints. On examination he had signs consistent with chronic liver disease and is noted to have a bronze discolouration of his skin.

4. 50 year old man presents with fever, nausea, muscle aches and mild jaundice. Tests show raised unconjugated bilirubin.

5. 42 year old overweight woman presents to the emergency department complaining of a 6-hour history of intense abdominal pain, nausea and vomiting. She noted having milder episodes in the past that resolved spontaneously. On examination you note she is Murphy’s sign positive.

ANSWERS

1. O

2. N

3. J

4. I

5. A