EMQs in Clinical Medicine.pdf - Peshawar Medical College

Jaundice 147
59 Jaundice
A
B
C
D
E
F
G
autoimmune hepatitis
hepatitis C
hepatitis A
iatrogenic hepatitis
rotor syndrome
primary biliary cirrhosis
hepatocellular carcinoma
H
I
J
K
L
M
Wilson’s disease
haemochromatosis
Gilbert’s syndrome
Dubin–Johnson syndrome
haemolytic anaemia
primary sclerosing cholangitis
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 24 year old presents with nausea, malaise and jaundice. He returned 3 weeks
ago from a holiday abroad. On examination he has a moderate hepatosplenomegaly
and tender cervical lymphadenopathy. He has dark urine and pale
stools.
2 A 35-year-old woman presents with fever, malaise and jaundice. On examination
she has moderate hepatomegaly. She is anti-smooth muscle antibody and antinuclear
antibody positive.
3 A 25-year-old man presents with recurrent episodes of asymptomatic jaundice.
4 A 4-year-old patient presents with anaemia and mild jaundice. Hb 7 g/dl,
reticulocytes 14 per cent. Electrophoresis result pending.
5 A 45-year-old man with ulcerative colitis presents with jaundice, pruritus and
abdominal pain. Alkaline phosphatase (ALP) is raised and anti-mitochondrial
antibodies negative.
Answers: see page 172.