Pathology EMQ template.

Name: Siree Wongrukmit

Theme: Viral Hepatitis

 

OPTION LIST

 

A

Cytomegalovirus

I

Herpes Simplex Virus

B

Epstein-Barr virus

J

Yellow Fever

C

Hepatitis A virus

K

 

D

Hepatitis B virus

L

 

E

Hepatitis C virus

M

 

F

Hepatitis D virus

N

 

G

Hepatitis E virus

O

 

H

Hepatitis G virus

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. An 18-year-old gap year student presents to clinic with itchy skin. She said her friend noticed that her skin has gone somewhat yellow. On questioning she mentions that she had been backpacking around Southeast Asia and recently arrived back in the UK. On observation, she looked mildly jaundiced and there was scleral icterus. On examination there was right upper quadrant pain and increased in liver size by 2cm below the costal margin.

 

2. A 57-year-old haemophiliac presents to his GP with fatigue, malaise, loss of appetite and confusion. On examination there was spider naevi, palmar erythema, various bruises and shifting dullness in the abdomen. His previous clotting factor transfusion occurred 4 weeks ago. He is a known carrier of Hepatitis B virus but has been previously asymptomatic.

 

3. A 24-year-old women presents to her GP with fever, sore throat, itchy and yellowing of the skin. On examination there was tonsillar enlargement, cervical lymphadenopathy, jaundice and yellowing of the sclera. The monospot test was positive.

 

4. A 35-year-old pregnant South-African lady presents to A&E with jaundice, nausea and confusion. On examination there was asterixis, fetor hepaticus and a positive Babinski sign. Her husband said that they arrived in the UK 2 weeks ago, and since then her symptoms have been getting rapidly worst. Anti-HEV antibodies and HEV-RNA were detected in serum.

 

5. A 65-year-old man presents to clinic with jaundice, nausea and fatigue. In the history he admits to losing 8kg of weight in the past 2 months. He also has a history of intravenous drug use in his 20s. You notice gross abdominal distension. On examination you find bruising, shifting dullness in the abdomen and a large craggy liver.

 

 

 

 

ANSWERS

1. C

2. F

3. B

4. G

5. E