USMLE Forum - Largest USMLE Community

Full Version: Jaundice? - vuyyuru
You're currently viewing a stripped down version of our content. View the full version with proper formatting.
A 16-year-old girl has a 1-month history of jaundice, mildly elevated aspartate aminotransferase and alanine aminotransferase levels, and an alkaline phosphatase level 3 times the normal value. Abdominal ultrasound findings were unremarkable, and liver biopsy showed nonspecific periportal edema/fibrosis. Which of the following diagnostic studies should be performed next?

A. Abdominal MRI
B. Cholecystokinin-stimulated hepatoiminodiacetic acid scan
C. Antimitochondrial antibody titer
D. Twenty-four“hour urine copper
E. Cholangiography

Young female, recent hx of jaundice, 3X Alk Phos, US normal, MRI non-specific periportal edema/fibrosis. It can be Wilson's disease and the choice, "D" is the only one goes with it.

She is too young for PBC, both GGT and Alk Phos are high, and the typical symptoms. It rules out choice C.

MRI is of no use one biopsy is already done.

B and E doesn't make sense.

This is my thought process, I don't have an article to back it up.