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Path questions imperialendo.co.uk > Liver and biliary disease > Flashcards

Liver and biliary disease Flashcards

1
Q

Choose the most appropriate answer from the list

  • Ascending cholangitis
  • Primary biliary cirrhosis
  • Carcinoma of the head of the pancreas
  • Primary sclerosing cholangitis
  • Cholangiocarcinoma
  • Wilson’s disease
  • Common bile duct stone
  • Dubin-Johnson syndrome
  • Gilbert’s syndrome
  • Haemolytic jaundice
  • Pancreatitis

25 year old man presents with jaundice, fever, and right upper quadrant pain.

A

Ascending cholangitis

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2
Q

Choose the most appropriate answer from the list

  • Ascending cholangitis
  • Primary biliary cirrhosis
  • Carcinoma of the head of the pancreas
  • Primary sclerosing cholangitis
  • Cholangiocarcinoma
  • Wilson’s disease
  • Common bile duct stone
  • Dubin-Johnson syndrome
  • Gilbert’s syndrome
  • Haemolytic jaundice
  • Pancreatitis

25 year old man presents with a 3 year history of occasional episodes of mild jaundice that worsened during a chest infection. He has mild unconjugated hyperbilirubinaemia with a normal liver biopsy.

A

Gilbert’s syndrome

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3
Q

Choose the most appropriate answer from the list

  • Ascending cholangitis
  • Primary biliary cirrhosis
  • Carcinoma of the head of the pancreas
  • Primary sclerosing cholangitis
  • Cholangiocarcinoma
  • Wilson’s disease
  • Common bile duct stone
  • Dubin-Johnson syndrome
  • Gilbert’s syndrome
  • Haemolytic jaundice
  • Pancreatitis

45 year old lady presents with mildly elevated serum bilirubin, normal alkaline phosphatase and AST, and anaemia. No urinary bilirubin present.

A

Haemolytic jaundice

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4
Q

Choose the most appropriate answer from the list

  • Ascending cholangitis
  • Primary biliary cirrhosis
  • Carcinoma of the head of the pancreas
  • Primary sclerosing cholangitis
  • Cholangiocarcinoma
  • Wilson’s disease
  • Common bile duct stone
  • Dubin-Johnson syndrome
  • Gilbert’s syndrome
  • Haemolytic jaundice
  • Pancreatitis

28 year old man presents with mildly elevated serum bilirubin, normal alkaline phosphatase and AST, and normal haemoglobin. No urinary bilirubin present.

A

Gilbert’s syndrome

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5
Q

Choose the most appropriate answer from the list

  • Ascending cholangitis
  • Primary biliary cirrhosis
  • Carcinoma of the head of the pancreas
  • Primary sclerosing cholangitis
  • Cholangiocarcinoma
  • Wilson’s disease
  • Common bile duct stone
  • Dubin-Johnson syndrome
  • Gilbert’s syndrome
  • Haemolytic jaundice
  • Pancreatitis

32 year old lady with a history of inflammatory bowel disease presents with intermittent jaundice, itching, weight loss, and pain in the right hypochondrium. Alkaline phosphatase levels are raised.

A

Primary sclerosing cholangitis

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6
Q

A 35 year old lady presents with a 2 week history of fatigue, upper abdominal discomfort and yellow skin. On examination there are no signs of chronic liver disease. Blood tests reveal a bilirubin of 235umol/L, ALT of 42IU/L, an AST of 39U/L and ALP of 20U/L. ANA (antinuclear antibodies) and ASMA (anti-smooth muscle antibodies) are positive.

Rank the following diagnoses given this information, putting the MOST LIKELY diagnosis first, and the least likely diagnosis last.

a) Autoimmune hepatitis
b) Gallstones
c) Primary biliary cirrhosis
d) Cholangiocarcinoma
e) Viral hepatitis

A 
Autoimmune hepatitis
Primary biliary cirrhosis
Viral hepatitis
Gallstones
Cholangiocarcinoma
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7
Q

Choose the most appropriate answer from the list

  • a1-antitrypsin deficiency
  • hepatic adenoma
  • autoimmune hepatitis
  • hepatocellular carcinoma
  • Budd-Chiari syndrome
  • hereditary haemochromatosis
  • cholangiocarcinoma
  • primary biliary cirrhosis
  • haemosiderosis
  • primary sclerosing cholangitis
  • hepatitis B
  • secondary biliary cirrhosis
  • hepatitis C
  • steatohepatitis
  • hepatoblastoma
  • Wilson’s disease

A 45 year old woman complains of fatigue and pruritus. She has also been experiencing some abdominal discomfort. On examination, xanthelasmas are found. Blood tests reveal elevated serum alkaline phosphatase and cholesterol. Antimitochondrial antibodies are present.

A

Primary biliary cirrhosis

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8
Q

Choose the most appropriate answer from the list

  • a1-antitrypsin deficiency
  • hepatic adenoma
  • autoimmune hepatitis
  • hepatocellular carcinoma
  • Budd-Chiari syndrome
  • hereditary haemochromatosis
  • cholangiocarcinoma
  • primary biliary cirrhosis
  • haemosiderosis
  • primary sclerosing cholangitis
  • hepatitis B
  • secondary biliary cirrhosis
  • hepatitis C
  • steatohepatitis
  • hepatoblastoma
  • Wilson’s disease

A 32 year old woman presents very concened about a mass she has noticed in her right upper quadrant. She otherwise feels well, and takes no medication other than the oral contraceptive pill, which she has been taking for 8 years. Serum AST, ALT and AFP are within normal ranges. Following further investigation she is advised to discontinue the oral contracepive pill and avoid becoming pregnant.

A

Hepatic adenoma

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9
Q

Choose the most appropriate answer from the list

  • a1-antitrypsin deficiency
  • hepatic adenoma
  • autoimmune hepatitis
  • hepatocellular carcinoma
  • Budd-Chiari syndrome
  • hereditary haemochromatosis
  • cholangiocarcinoma
  • primary biliary cirrhosis
  • haemosiderosis
  • primary sclerosing cholangitis
  • hepatitis B
  • secondary biliary cirrhosis
  • hepatitis C
  • steatohepatitis
  • hepatoblastoma
  • Wilson’s disease

A 38 year old woman with presents with rapidly developing abdominal pain and confusion. Hepatomegaly, ascites, peripheral oedema and a flapping tremor are found on examination. Blood tests revealed polycythemia, and on Doppler ultrasonography no flow was observed in the hepatic veins.

A

Budd-Chiari syndrome

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10
Q

Choose the most appropriate answer from the list

  • a1-antitrypsin deficiency
  • hepatic adenoma
  • autoimmune hepatitis
  • hepatocellular carcinoma
  • Budd-Chiari syndrome
  • hereditary haemochromatosis
  • cholangiocarcinoma
  • primary biliary cirrhosis
  • haemosiderosis
  • primary sclerosing cholangitis
  • hepatitis B
  • secondary biliary cirrhosis
  • hepatitis C
  • steatohepatitis
  • hepatoblastoma
  • Wilson’s disease

A 40 year old ex-IV drug user is feeling tired all the time and having difficulty concentrating. He has noticed his skin appearing slightly yellow in the past. Serum transaminases are elevated. Further investigation reveals infection with a single-stranded RNA virus.

A

Hepatitis C

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11
Q

Choose the most appropriate answer from the list

  • a1-antitrypsin deficiency
  • hepatic adenoma
  • autoimmune hepatitis
  • hepatocellular carcinoma
  • Budd-Chiari syndrome
  • hereditary haemochromatosis
  • cholangiocarcinoma
  • primary biliary cirrhosis
  • haemosiderosis
  • primary sclerosing cholangitis
  • hepatitis B
  • secondary biliary cirrhosis
  • hepatitis C
  • steatohepatitis
  • hepatoblastoma
  • Wilson’s disease

A 67 year old woman with a history of ulcerative colitis and primary sclerosing cholangitis presents with jaundice, dark urine and itching. An ultrasound reveals biliary tree dilatation and no gallstones are found. An ERCP is performed and biliary brush cytology shows cellular discohesion and a high nuclear/cytoplasmic ratio.

A

Cholangiocarcinoma

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12
Q

Choose the most appropriate answer from the list

  • AST
  • Primary sclerosing cholangitis
  • ALT
  • ALKP
  • Alcoholic cirrhosis
  • Conjugated bilirubin
  • Portal hypertension
  • Ascending cholangitis
  • Unconjugated bilirubin
  • Viral hepatitis
  • Primary biliary cirrhosis

Which enzyme is elevated most in alcoholic hepatitis?

A

ALT

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13
Q

Choose the most appropriate answer from the list

  • AST
  • Primary sclerosing cholangitis
  • ALT
  • ALKP
  • Alcoholic cirrhosis
  • Conjugated bilirubin
  • Portal hypertension
  • Ascending cholangitis
  • Unconjugated bilirubin
  • Viral hepatitis
  • Primary biliary cirrhosis

Which condition is associated with ulcerative colitis?

A

Primary sclerosing cholangitis

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14
Q

Choose the most appropriate answer from the list

  • AST
  • Primary sclerosing cholangitis
  • ALT
  • ALKP
  • Alcoholic cirrhosis
  • Conjugated bilirubin
  • Portal hypertension
  • Ascending cholangitis
  • Unconjugated bilirubin
  • Viral hepatitis
  • Primary biliary cirrhosis

Which condition is often associated with anti-mitochondrial antibodies?

A

Primary biliary cirrhosis

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15
Q

Choose the most appropriate answer from the list

  • AST
  • Primary sclerosing cholangitis
  • ALT
  • ALKP
  • Alcoholic cirrhosis
  • Conjugated bilirubin
  • Portal hypertension
  • Ascending cholangitis
  • Unconjugated bilirubin
  • Viral hepatitis
  • Primary biliary cirrhosis

Which enzyme is higher in growing children?

A

ALKP

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16
Q

Choose the most appropriate answer from the list

  • AST
  • Primary sclerosing cholangitis
  • ALT
  • ALKP
  • Alcoholic cirrhosis
  • Conjugated bilirubin
  • Portal hypertension
  • Ascending cholangitis
  • Unconjugated bilirubin
  • Viral hepatitis
  • Primary biliary cirrhosis

What is increased in patients with Gilberts disease?

A

Unconjugated bilirubin

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17
Q

Choose the most appropriate answer from the list

  • Acute cholecystitis
  • Gilbert’s syndrome
  • Alpha-1-antitrypsin deficiency
  • Haemochromatosis
  • Ascending cholangitis
  • Lucey-Driscoll syndrome
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Biliary colic
  • Rotor syndrome
  • Chronic cholecystitis
  • Sclerosing cholangitis
  • Crigler-Najjar syndrome
  • Viral hepatitis
  • Dubin-Johnson syndrome
  • Wilson’s disease

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.

A

Viral hepatitis

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18
Q

Choose the most appropriate answer from the list

  • Acute cholecystitis
  • Gilbert’s syndrome
  • Alpha-1-antitrypsin deficiency
  • Haemochromatosis
  • Ascending cholangitis
  • Lucey-Driscoll syndrome
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Biliary colic
  • Rotor syndrome
  • Chronic cholecystitis
  • Sclerosing cholangitis
  • Crigler-Najjar syndrome
  • Viral hepatitis
  • Dubin-Johnson syndrome
  • Wilson’s disease

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.

A

Sclerosing cholangitis

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19
Q

Choose the most appropriate answer from the list

  • Acute cholecystitis
  • Gilbert’s syndrome
  • Alpha-1-antitrypsin deficiency
  • Haemochromatosis
  • Ascending cholangitis
  • Lucey-Driscoll syndrome
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Biliary colic
  • Rotor syndrome
  • Chronic cholecystitis
  • Sclerosing cholangitis
  • Crigler-Najjar syndrome
  • Viral hepatitis
  • Dubin-Johnson syndrome
  • Wilson’s disease

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.

A

Haemochromatosis

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20
Q

Choose the most appropriate answer from the list

  • Acute cholecystitis
  • Gilbert’s syndrome
  • Alpha-1-antitrypsin deficiency
  • Haemochromatosis
  • Ascending cholangitis
  • Lucey-Driscoll syndrome
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Biliary colic
  • Rotor syndrome
  • Chronic cholecystitis
  • Sclerosing cholangitis
  • Crigler-Najjar syndrome
  • Viral hepatitis
  • Dubin-Johnson syndrome
  • Wilson’s disease

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

A

Gilbert’s syndrome

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21
Q

Choose the most appropriate answer from the list

  • Acute cholecystitis
  • Gilbert’s syndrome
  • Alpha-1-antitrypsin deficiency
  • Haemochromatosis
  • Ascending cholangitis
  • Lucey-Driscoll syndrome
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Biliary colic
  • Rotor syndrome
  • Chronic cholecystitis
  • Sclerosing cholangitis
  • Crigler-Najjar syndrome
  • Viral hepatitis
  • Dubin-Johnson syndrome
  • Wilson’s disease

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.

A

Acute cholecystitis

22
Q

Choose the most appropriate answer from the list

  • Albumin
  • Urobilinogen
  • ALP
  • ALT
  • AST
  • Bilirubin
  • Clearance of infection
  • Vitamin D hydroxylation
  • Prothrombin time

Pick the most accurate measure of liver synthetic function.

A

Prothrombin time

23
Q

Choose the most appropriate answer from the list

  • Albumin
  • Urobilinogen
  • ALP
  • ALT
  • AST
  • Bilirubin
  • Clearance of infection
  • Vitamin D hydroxylation
  • Prothrombin time

Which hepatic marker is more greatly raised in alcoholic liver disease and cirrhosis?

A

AST

24
Q

Choose the most appropriate answer from the list

  • Albumin
  • Urobilinogen
  • ALP
  • ALT
  • AST
  • Bilirubin
  • Clearance of infection
  • Vitamin D hydroxylation
  • Prothrombin time

What is the one of the main roles of the Kupffer cells?

A

Clearance of infection

25
Q

Choose the most appropriate answer from the list

  • Albumin
  • Urobilinogen
  • ALP
  • ALT
  • AST
  • Bilirubin
  • Clearance of infection
  • Vitamin D hydroxylation
  • Prothrombin time

Which marker is notably low in malnutrition?

A

Albumin

26
Q

Choose the most appropriate answer from the list

  • Albumin
  • Urobilinogen
  • ALP
  • ALT
  • AST
  • Bilirubin
  • Clearance of infection
  • Vitamin D hydroxylation
  • Prothrombin time

Which marker cannot be detected in extra-hepatic biliary obstruction?

A

Urobilinogen

27
Q

Choose the most appropriate answer from the list

  • Albumin
  • Bilirubin
  • ALP
  • Clotting factors
  • Alpha feto protein
  • Copper
  • Alpha-1 antitrypsin
  • GGT
  • ALT
  • INR
  • Anti mitochondrial antibodies
  • Iron
  • Anti smooth muscle antibodies
  • Viral serology
  • AST
  • Vitamin K

A 43 year old non drinker presents with pruritus, jaundice and pale stool. Which result would expect to be raised?

A

ALP

28
Q

Choose the most appropriate answer from the list

  • Albumin
  • Bilirubin
  • ALP
  • Clotting factors
  • Alpha feto protein
  • Copper
  • Alpha-1 antitrypsin
  • GGT
  • ALT
  • INR
  • Anti mitochondrial antibodies
  • Iron
  • Anti smooth muscle antibodies
  • Viral serology
  • AST
  • Vitamin K

This test can be used to distinguish between acute and chronic liver disease.

A

Albumin

29
Q

Choose the most appropriate answer from the list

  • Albumin
  • Bilirubin
  • ALP
  • Clotting factors
  • Alpha feto protein
  • Copper
  • Alpha-1 antitrypsin
  • GGT
  • ALT
  • INR
  • Anti mitochondrial antibodies
  • Iron
  • Anti smooth muscle antibodies
  • Viral serology
  • AST
  • Vitamin K

A 50 year old woman presents with very dry eyes, jaundice, splenomegaly and xanthalasma. This test will likely confirm your diagnosis.

A

Anti mitochondrial antibodies

30
Q

Choose the most appropriate answer from the list

  • Albumin
  • Bilirubin
  • ALP
  • Clotting factors
  • Alpha feto protein
  • Copper
  • Alpha-1 antitrypsin
  • GGT
  • ALT
  • INR
  • Anti mitochondrial antibodies
  • Iron
  • Anti smooth muscle antibodies
  • Viral serology
  • AST
  • Vitamin K

A 36 year old non smoker presents with SOB and a CXR shows hyperinflation. Which test would confirm your diagnosis?

A

Alpha-1 antitrypsin

31
Q

Choose the most appropriate answer from the list

  • Albumin
  • Bilirubin
  • ALP
  • Clotting factors
  • Alpha feto protein
  • Copper
  • Alpha-1 antitrypsin
  • GGT
  • ALT
  • INR
  • Anti mitochondrial antibodies
  • Iron
  • Anti smooth muscle antibodies
  • Viral serology
  • AST
  • Vitamin K

A man presents with a recent history of MI, you might find this to be raised.

A

AST

32
Q

Choose the most appropriate answer from the list

  • Wilsons disease
  • AIH
  • ALD
  • PSC
  • HCC
  • Hepatitis C
  • Cholangiocarcinoma
  • Paracetemol OD
  • Budd Chiari Syndrome
  • Haemochromatosis
  • Hepatitis B
  • PBC
  • Warfarin therapy
  • Pregnancy
  • Gilberts syndrome
  • Hepatitis A

A 37yo lady with chronic hep C has a rising AFP

A

HCC

33
Q

Choose the most appropriate answer from the list

  • Wilsons disease
  • AIH
  • Alcoholic liver disease
  • PSC
  • HCC
  • Hepatitis C
  • Cholangiocarcinoma
  • Paracetemol OD
  • Budd Chiari Syndrome
  • Haemochromatosis
  • Hepatitis B
  • PBC
  • Warfarin therapy
  • Pregnancy
  • Gilberts syndrome
  • Hepatitis A

A 20yo gentleman who complains that his ‘eyes go yellow on occasion’ has a raised bilirubin. No other symptoms

A

Gilberts syndrome

34
Q

Choose the most appropriate answer from the list

  • Wilsons disease
  • AIH
  • Alcoholic liver disease
  • PSC
  • HCC
  • Hepatitis C
  • Cholangiocarcinoma
  • Paracetemol OD
  • Budd Chiari Syndrome
  • Haemochromatosis
  • Hepatitis B
  • PBC
  • Warfarin therapy
  • Pregnancy
  • Gilberts syndrome
  • Hepatitis A

A 40yo lady with fatigue, pruritus, jaundice and xanthoma. LFTs show elevated GGT and ALP. Antimitochondrial antibody also present

A

PBC

35
Q

Choose the most appropriate answer from the list

  • Wilsons disease
  • AIH
  • Alcoholic liver disease
  • PSC
  • HCC
  • Hepatitis C
  • Cholangiocarcinoma
  • Paracetemol OD
  • Budd Chiari Syndrome
  • Haemochromatosis
  • Hepatitis B
  • PBC
  • Warfarin therapy
  • Pregnancy
  • Gilberts syndrome
  • Hepatitis A

A 50yo gentleman with raised AST, ALT, ALP, GGT and a low albumin. AST:ALT ratio is 2.3

A

Alcoholic liver disease

36
Q

Choose the most appropriate answer from the list

  • Wilsons disease
  • AIH
  • Alcoholic liver disease
  • PSC
  • HCC
  • Hepatitis C
  • Cholangiocarcinoma
  • Paracetemol OD
  • Budd Chiari Syndrome
  • Haemochromatosis
  • Hepatitis B
  • PBC
  • Warfarin therapy
  • Pregnancy
  • Gilberts syndrome
  • Hepatitis A

A 19yo gentleman has just returned to England from Thailand, complains of fever and tiredness over the last 8 days increasing ‘yellowing’ in the last 2 days. He has a raised ALT, AST, ALP and bilirubin. IGM antibodies present

A

Hepatitis A

37
Q

Choose the most appropriate answer from the list

  • Cytomegalovirus
  • Herpes Simplex Virus
  • Epstein-Barr virus
  • Yellow Fever
  • Hepatitis A virus
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatitis D virus
  • Hepatitis E virus
  • Hepatitis G virus

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.

A

Hepatitis A virus

38
Q

Choose the most appropriate answer from the list

  • Cytomegalovirus
  • Herpes Simplex Virus
  • Epstein-Barr virus
  • Yellow Fever
  • Hepatitis A virus
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatitis D virus
  • Hepatitis E virus
  • Hepatitis G virus

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.

A

Hepatitis D virus

39
Q

Choose the most appropriate answer from the list

  • Cytomegalovirus
  • Herpes Simplex Virus
  • Epstein-Barr virus
  • Yellow Fever
  • Hepatitis A virus
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatitis D virus
  • Hepatitis E virus
  • Hepatitis G virus

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.

A

Epstein-Barr virus

40
Q

Choose the most appropriate answer from the list

  • Cytomegalovirus
  • Herpes Simplex Virus
  • Epstein-Barr virus
  • Yellow Fever
  • Hepatitis A virus
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatitis D virus
  • Hepatitis E virus
  • Hepatitis G virus

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.

A

Hepatitis E virus

41
Q

Choose the most appropriate answer from the list

  • Cytomegalovirus
  • Herpes Simplex Virus
  • Epstein-Barr virus
  • Yellow Fever
  • Hepatitis A virus
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatitis D virus
  • Hepatitis E virus
  • Hepatitis G virus

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.

A

Hepatitis C virus

42
Q

Choose the most appropriate answer from the list

  • Hepatitis A
  • Anti-HBs
  • Hepatitis B
  • Anti-HBe
  • Hepatitis C
  • Anti-HBC IgM
  • Hepatitis D
  • Anti-HBC IgG
  • Hepatitis E
  • ALT
  • Hepatitis F
  • AST
  • HBsAg
  • ALP
  • HBeAg
  • Albumin

45 year-old, male healthcare worker. He sustained a needlestick injury from a patient with infectious hepatitis B. However, he only reported the incident 3 months later, blood was then taken.

A

HBsAg

43
Q

Choose the most appropriate answer from the list

  • Hepatitis A
  • Anti-HBs
  • Hepatitis B
  • Anti-HBe
  • Hepatitis C
  • Anti-HBC IgM
  • Hepatitis D
  • Anti-HBC IgG
  • Hepatitis E
  • ALT
  • Hepatitis F
  • AST
  • HBsAg
  • ALP
  • HBeAg
  • Albumin

19 year-old, male. He just came back from his gap year. He complains of tiredness and loss of appetite. He was febrile on examination.

A

Hepatitis A

44
Q

Choose the most appropriate answer from the list

  • Hepatitis A
  • Anti-HBs
  • Hepatitis B
  • Anti-HBe
  • Hepatitis C
  • Anti-HBC IgM
  • Hepatitis D
  • Anti-HBC IgG
  • Hepatitis E
  • ALT
  • Hepatitis F
  • AST
  • HBsAg
  • ALP
  • HBeAg
  • Albumin

37 year-old, female. Insignificant findings on examination with normal LFTs. She has been vaccinated with hepatitis B.

A

Anti-HBs

45
Q

Choose the most appropriate answer from the list

  • Hepatitis A
  • Anti-HBs
  • Hepatitis B
  • Anti-HBe
  • Hepatitis C
  • Anti-HBC IgM
  • Hepatitis D
  • Anti-HBC IgG
  • Hepatitis E
  • ALT
  • Hepatitis F
  • AST
  • HBsAg
  • ALP
  • HBeAg
  • Albumin

69 year-old, male. Confused on admission. Raised MCV with abnormal LFTs. Previously received a blood transfusion. Culture revealed a RNA virus.

A

Hepatitis C

46
Q

Choose the most appropriate answer from the list

  • Hepatitis A
  • Anti-HBs
  • Hepatitis B
  • Anti-HBe
  • Hepatitis C
  • Anti-HBC IgM
  • Hepatitis D
  • Anti-HBC IgG
  • Hepatitis E
  • ALT
  • Hepatitis F
  • AST
  • HBsAg
  • ALP
  • HBeAg
  • Albumin

25 year-old, female. Recovered from previous hepatitis B infection. Blood test showed positive anti-HBs and………

A

Anti-HBC IgG

47
Q

Choose the most appropriate answer from the list

  • Anti-HAV IgG
  • Hepatitis C
  • Anti-HAV IgM
  • Hepatitis D
  • Anti-HBe
  • Hepatitis E
  • Anti-HBs
  • HBeAg
  • HBsAg
  • Hepatitis A
  • Hepatitis B

A final year medical student, who has recently returned from her elective in a seaside village in the Far East, presents to A&E complaining of a fever, joint pains and a loss of appetite. Which marker is most likely to be elevated?

A

Anti-HAV IgM

48
Q

Choose the most appropriate answer from the list

  • Anti-HAV IgG
  • Hepatitis C
  • Anti-HAV IgM
  • Hepatitis D
  • Anti-HBe
  • Hepatitis E
  • Anti-HBs
  • HBeAg
  • HBsAg
  • Hepatitis A
  • Hepatitis B

A 56 year old gentleman, with a past history of intravenous drug use, has been prescribed PEGinterferon-α. Which marker is most likely to be present in the blood?

A

HBsAg

49
Q

Choose the most appropriate answer from the list

  • Anti-HAV IgG
  • Hepatitis C
  • Anti-HAV IgM
  • Hepatitis D
  • Anti-HBe
  • Hepatitis E
  • Anti-HBs
  • HBeAg
  • HBsAg
  • Hepatitis A
  • Hepatitis B

On examination of a liver biopsy of a patient who carries the hepatitis B virus, the histopathologist notes the presence of an incomplete RNA virus. Which hepatic virus is this most likely to be?

A

Hepatitis D

50
Q

Choose the most appropriate answer from the list

  • Anti-HAV IgG
  • Hepatitis C
  • Anti-HAV IgM
  • Hepatitis D
  • Anti-HBe
  • Hepatitis E
  • Anti-HBs
  • HBeAg
  • HBsAg
  • Hepatitis A
  • Hepatitis B

A first year medical student has recently been vaccinated against hepatitis B virus. She visits her GP for a blood test. Which marker is most likely to be present in the blood?

A

Anti-HBs

51
Q

Choose the most appropriate answer from the list

  • Anti-HAV IgG
  • Hepatitis C
  • Anti-HAV IgM
  • Hepatitis D
  • Anti-HBe
  • Hepatitis E
  • Anti-HBs
  • HBeAg
  • HBsAg
  • Hepatitis A
  • Hepatitis B

On his elective in Asia, a medical student learns of the death of a pregnant woman who was infected by a hepatic virus. Which virus is the most likely cause?

A

Hepatitis E

Path questions imperialendo.co.uk (44 decks)

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