Block 3

Question 1

A 54-year-old man presents with a high fever, jaundice, and colicky abdominal pain in the right upper quadrant. The gallbladder cannot be palpated on physical examination. Workup reveals hemoglobin level of 15.3 g/dL, unconjugated bilirubin level of 0.9 mg/dL, conjugated bilirubin level of 1.1 mg/dL, and alkaline phosphatase level of 180 IU/L. Which of the following is the most likely diagnosis?

a. Acute cholecystitis
b. Chronic cholecystitis
c. Bile duct obstruction by a stone
d. Carcinoma of the gallbladder
e. Carcinoma of the head of the pancreas

Answer 1

c. Bile duct obstruction by a stone

Question 2

A 29 year old Caucasian male experiences fever, fatigue, joint pain and urticaria-type skin rash once the symptoms start to abate a surge of serum alanine aminotranferase, ALT and aspartate aminotransferase, AST is noted. This patient most likely suffers from 
A. Hemochromatosis 
B. Hepatic Steatosis 
C. Gilbert Syndrome 
D. Acute Viral Hepatitis B 
E. Wilson's disease

Answer 2

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Question 3

Germ line mutations in the cationic trypsinogen (PRSS1) gene can produce an autosomal dominant disorder that usually begins in childhood and is characterized by recurrent bouts of severe inflammation that pro- duces which one of the listed disorders?

a. Acute cholecystitis
b. Acute colitis
c. Acute pancreatitis
d. Chronic gastritis
e. Chronic hepatitis

Answer 3

?????

Question 4

The figure shows the cut surface of the liver removed at autopsy from a 49 year old man with a history of alcohol abuse. what is the histological feature that is characteristically associated with alcoholic hepatitis?

A. Cholestasis 
B. Steatosis
C. Lymphocytic infiltrates
D. Fibrosis 
E. Mallory's hyaline

Answer 4

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