Hepatobiliary Disease USMLE Step 1 Practice Question
A 34-year-old man with a 10-year history of ulcerative colitis presents with progressive pruritus and fatigue. Vital signs show BP 128/82, HR 88, RR 16, temperature 37.2°C, and SpO2 98%. Laboratory studies reveal elevated alkaline phosphatase (245 U/L) and conjugated bilirubin (2.8 mg/dL), with normal transaminases. Abdominal ultrasound shows no gallstones. ERCP demonstrates multifocal strictures with intervening dilation of intrahepatic and extrahepatic bile ducts. Which diagnosis best explains these findings?
Answer choices
- APrimary sclerosing cholangitisCorrect answer
- BAcute cholangitis
- CAutoimmune hepatitis
- DCholedocholithiasis
- EPrimary biliary cholangitis
- FBiliary strictures secondary to pancreatitis
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