Hepatobiliary Disease USMLE Step 1 Practice Question
A 27-year-old woman presents with chronic mild jaundice noted on routine examination. Vital signs are stable: BP 118/76 mmHg, HR 82 bpm, RR 16/min, temp 37°C, SpO2 98%. Laboratory studies show conjugated hyperbilirubinemia of 3.2 mg/dL with normal alkaline phosphatase and transaminases. Abdominal ultrasound shows no biliary obstruction or cirrhosis. Liver biopsy reveals coarse brown-black pigment within hepatocytes. She takes no medications. Which diagnosis best explains these findings?
Answer choices
- AGilbert syndrome
- BPrimary biliary cholangitis
- CDubin-Johnson syndromeCorrect answer
- DRotor syndrome with black liver pigmentation
- ECrigler-Najjar syndrome
- FHemolytic anemia with secondary bilirubinemia
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