Hepatobiliary Disease USMLE Step 1 Practice Question
A 35-year-old woman with polycythemia vera presents with acute onset right upper quadrant pain and abdominal distension. Vital signs show BP 128/82 mmHg, HR 98/min, RR 16/min, temperature 37.2°C. Physical examination reveals hepatomegaly and ascites; splenomegaly is absent. Abdominal ultrasound with Doppler demonstrates hepatic vein thrombosis with reversed flow. Laboratory studies show elevated transaminases and INR 1.3. Which of the following is the most likely diagnosis?
Answer choices
- ABudd-Chiari syndromeCorrect answer
- BPrimary sclerosing cholangitis
- CHepatic encephalopathy
- DAcute cholangitis
- ESpontaneous bacterial peritonitis
- FMembranous obstruction of the inferior vena cava
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