Hepatobiliary Disease USMLE Step 1 Practice Question
A 35-year-old woman with polycythemia vera presents with acute right upper quadrant pain and abdominal distension. Vital signs show BP 128/82 mmHg, HR 98/min, RR 16/min, temp 37.2°C. Physical examination reveals hepatomegaly and tense ascites. Doppler ultrasound demonstrates absent hepatic venous flow with heterogeneous liver echotexture. Laboratory studies show INR 1.8 and elevated bilirubin at 2.4 mg/dL. She denies recent trauma or alcohol use. Which diagnosis best explains these findings?
Answer choices
- ABudd-Chiari syndromeCorrect answer
- BNutcracker syndrome
- CAcute cholecystitis
- DPrimary biliary cholangitis
- EPortal vein thrombosis with cavernous transformation only
- FHepatic abscess with sepsis
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