EMCQ :Jaundice



A autoimmune hepatitis
B hepatitis C
C hepatitis A
D iatrogenic hepatitis
E rotor syndrome
F primary biliary cirrhosis
G hepatocellular carcinoma

H Wilsons disease
I haemochromatosis
J Gilberts syndrome
K DubinJohnson syndrome
L haemolytic anaemia
M 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 palestools.

2 A 35-year-old woman presents with fever, malaise and jaundice. On examination she has moderate hepatomegaly. She is antismooth muscle antibody and anti-nuclear 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 7g/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.


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