Name: Mili islam

Theme: Liver Disease

OPTION LIST

A	Alcoholic Liver Disease	I
B	Autoimmune Hepatitis	J
C	Hepatitis A	K
D	Hepatitis B	L
E	Hepatocellular Carcinoma	M
F	Hereditary Heamochromatosis	N
G	Primary Biliary Cirrhosis	O
H	Wilson’s Disease	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 25 year old student presents to A&E complaining of abdominal pain, diarrhoea, nausea and vomiting over the past few days. On examination he appears jaundiced and has dark urine and pale stools. Blood tests reveal raised levels of AST, ALT and bilirubin and a raised ESR. Further questioning reveals that he has returned from South East Asia three weeks previously.

2. A 45 year old lady complains of pruritis. Investigations reveal the presence of antimitochondrial antibodies and elevated levels of alkaline phosphatase.

3. A 17 year old female presents to outpatients complaining of increasing confusion and a mild tremor. On examination you notice signs of liver disease. Investigations reveal a haemolytic anaemia. Further examination reveals a green-brown discolouration at the peripheries of her corneas.

4. A 45 year old male was admitted to hospital after having a fall. Investigations reveal a leucocytosis with elevated bilirubin and transferases. Levels were albumin, folate and vitamin B12 were low. Clotting studies showed a prolonged prothrombin time.

5. Routine biochemistry for a 32 year old man revealed elevated levels of serum iron and ferratin but reduced levels of total iron binding capacity. Other serum liver biochemistry investigations were normal. Further questioning revealed that his uncle had a ‘blood’ disorder.

ANSWERS

1. C

2. G

3. H

4. A

5.F