Hepatobiliary Disease USMLE Step 1 Practice Question
A 17-year-old boy presents with tremor, dysarthria, and behavioral changes. Vital signs show BP 118/76 mmHg, HR 88/min, RR 16/min, temperature 37°C, and SpO2 98% on room air. He has mild jaundice and slit-lamp examination reveals Kayser-Fleischer rings at the corneal periphery. Laboratory studies show elevated transaminases and ceruloplasmin level of 18 mg/dL (normal 20-40). He denies abdominal pain. Which of the following laboratory findings is most likely present?
Answer choices
- AMarkedly increased ferritin with high transferrin saturation
- BPositive hepatitis B surface antigen only
- CElevated alpha-1 antitrypsin level
- DDecreased ceruloplasmin levelCorrect answer
- EPositive anti-mitochondrial antibodies
- FIncreased serum copper level with decreased urinary copper excretion
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