Pathology EMQ template.

Name: Jonathan Lenihan

Candidate number:

Theme: Liver and Biliary Disease

OPTION LIST

A	Wilson’s Disease	I	Primary Biliary Cirrhosis
B	Hepatitis B	J	Acute Cholecystitis
C	Acute pancreatitis	K	Ascending Cholangitis
D	Hepatocellular Carcinoma	L	Primary Sclerosing Cholangitis
E	Amoebic Abscess	M	Hepatitis A
F	Haemochromatosis	N	Gallstones
G	Gilbert’s Syndrome	O	Pancreatic Carcinoma
H	Autoimmune haemolytic anaemia	P	Alpha1-Antitrypsin deficiency

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 24 year old man presents to A&E. He has just returned from a cultural 2 week holiday in India, and is complaining of abdominal pain and a slight fever. In addition he confesses to several episodes of vomiting and diarrhoea. LFTs show raised AST and ALT.

2. A 47 year old lady complains of intense itching over her body. She is not jaundiced but examination reveals hepatosplenomegaly and xanthelasma. Her ALP is 1052 U/L and AMA’s are present.

3. A 66 year old chronic alcohol abuser presents with 1 month unintentional weight loss, ascites and abdominal pain. His serum alpha-fetoprotein is normal, but CT scanning demonstrates large filling defects.

4. A 42 year old female presents with pain localised to the right upper quadrant of her abdomen that has worsened considerably in the last hour. She has fever, tenderness, guarding and a +ve Murphy’s sign.

5. A 32 year old lady presents with slight jaundice. Her FBC, smear and reticulocyte counts are normal. Her LFTs are grossly normal except for a finding of unconjugated hyperbilirubinaemia.

ANSWERS

1. M

2. I

3. D

4. J

5. G