Name: Nikhil Ladwa

Theme: Liver Disease

 

OPTION LIST

 

A

Alpha – 1 – Antitrypsin deficiency

I

Wilsons Disease

B

Hepatocellular Carcinoma

J

Primary Sclerosing Cholangitis

C

Hepatitis C

K

Hereditary Haemochromatosis

D

Ascending Cholangitis

L

 

E

Hepatitis B

M

 

F

Budd-Chiari Syndrome

N

 

G

Primary Biliary Cirrhosis

O

 

H

Alcoholic Hepatitis

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 30 year old female patient presents with abdominal pain, nausea and vomiting. Upon examination the patient has a tender hepatomegaly and ascites (with a high protein content) Abdominal CT demonstrated hepatic vein occlusion with diffuse abnormal parenchyma on contrast enhancement.

 

2.  A 35 year old patient with known Hepatitis B visits the doctor complaining of recent weight loss, loss of appetite, fevers and an ache in the right hypochondrium. On examination an enlarged, irregular, tender liver can be palpated.

 

3. A 15 year old boy presents with signs and symptoms of chronic liver disease. Upon examination Kayser-Fleisher rings are seen in the patients corneas.

 

4.  A 22 year old patient presents to his doctor complaining of week long flu like symptoms, nausea, anorexia and fatigue. The patient appears jaundiced upon examination with mild enlargement and slight tenderness of the liver. Lab results demonstrate a raised AST (512 IU/L) and ALT (425IU/L) and an acute phase IgM response has been demonstrated. The patient recalls visiting a dodgy tattoo parlour 3 weeks ago to engrave the name of his mum on his arm.

 

5.  A 42 year old woman presents to the doctor complaining of severe itching and recent onset of jaundice. The patient had been experiencing milder pruritis and bouts of fatigue for the last year. Hepatomegaly and pigmented xantholasma are demonstrated upon examination. Serum IgM is high and apart from a high serum Alk Phosphate, other liver biochemistry is normal. Upon ELISA screen, mitochondrial antibodies are seen. (in titre of 1:200)

 

ANSWERS

1.  F

2. B

3. I

4.  E

5. G