JCU MB4 Term 2 Week 3 (Liver)

1

Viral serology interpretation: HBsAg +ve, HBcAb +ve, HBcAb IgM -ve, HBeAg +ve


2

51yo male, alcohol. Picture of abdomen shown - what is the pathogenesis of the indicated feature?

Cirrhosis - Ascites


3

The pathogenesis pathway shown in the illustration is typical of which virus?

Pathogenesis - Hepatitis


4

42yo male, alcoholic, fatigue. Liver biopsy is shown. What is the likely diagnosis?

Liver Biopsy - Chronic Hepatitis


5

A 42yo travelling salesman has routine medical test for insurance. Following initial testing he was advised a liver biopsy. The biopsy image is shown. What is the most likely diagnosis?

Liver Biopsy - Acute Hepatitis


6

Viral serology interpretation: HBsAg -ve, HBcAb -ve, HBsAb +ve


7

Viral serology interpretation: HBsAg negative, HBsAb +ve, HBcAb +ve, HBcAb IgM -ve.


8

Lab investigation interpretation:

  • Protein (Total): 59g/L
  • Albumin: 30g/L
  • Globulin: 29g/L
  • Bilirubin (Total): 27µmol/L
  • ALP: 71U/L
  • GGT: 523U/L
  • ALT: 79U/L
  • AST: 151U/L


9

Lab investigation interpretation:

  • Urea: 5.8mmol/L
  • Creatinine: 80µmol/L
  • Protein (Total): 66g/L
  • Albumin: 35g/L
  • Globulin: 31g/L
  • Bilirubin (total): 192µmol/L
  • Bilirubin (conjugated): 130µmol/L
  • ALP: 203U/L
  • GGT: 470U/L
  • ALT: 6055U/L
  • AST: 4860U/L


10

28yo male, alcoholic, homosexual, icterus and fever. Liver biopsy is shown. What is the diagnosis?

Liver Biopsy - Acute Hepatitis


11

69yo female, chronic bronchitis. Died following chronic cardiac failure. Liver specimen shown. What is the likely diagnosis?

Liver - Nutmeg Liver


12

62yo male, malaise, lethargy for 2 years. Mild hepatomegaly, no jaundice. Liver function tests are normal. Liver biopsy shown. What is the most likely diagnosis?

Liver Biopsy - Fatty Liver


13

22yo male, alcoholic, 3 weeks of fatigue, icterus and fever. Liver biopsy shown. What is the structure identified by the arrow?

Liver Biopsy - Necrosis


14

34yo male, icterus and fever. Liver biopsy shown. What is the likely diagnosis?

Liver Biopsy - Acute Hepatitis


15

51yo male, alcohol. Picture of abdomen shown - what is the pathogenesis of the indicated feature?

Cirrhosis - Gynecomastia


16

56yo chronic alcoholic, 2 days fever, abdomen distended, tender, tap yielded cloudy yellow fluid with 98% neutrophils. Blood culture grows E. coli. Patient dies 3 days later. Liver image shown. What is the likely diagnosis?

Liver - Cirrhosis


17

58yo male, alcoholic, distended abdomen and icterus. Liver biopsy shown. What is the likely diagnosis?

Liver Biopsy - Cirrhosis


18

51yo male, alcoholic, history of surgery for pigmented skin lesion. Liver specimen shown. What is the likely diagnosis?

Liver - Metastatic Melanoma


19

59yo male, alcoholic, presents with fatigue, anorexia. Normal liver function tests. Liver specimen shown. What is the likely diagnosis?

Liver - Fatty Liver


20

22yo male, alcoholic, 3 weeks of fatigue, icterus and fever. Liver biopsy is shown. Identify the structure indicated.

Liver Biopsy - Mallor Hyaline


21

28yo male, 3 weeks after visiting east timor presents with malaise, fatigue, loss of appetite. Mild icterus. AST and ALT mild elevation. Total bilirubin 3.9mg/dL (direct 2.8). Which of the following would be positive?


22

41yo female, increasing malaise, 10kg weight loss since last year. Developed coma and died. Liver specimen shown. What is the most likely etiologic agent?

Liver - HCC


23

A 48yo male is referred following high ALT in health screening. HCV immunoassay positive. Past history of appendicectomy 10 years ago. Examination is normal. Which of the following tests would determine if he has chronic HCV infection?