Hepatobiliary Disease USMLE Step 1 Practice Question
A 23-year-old woman presents 24 hours after acetaminophen overdose with nausea, right upper quadrant pain, and jaundice. Vital signs: BP 110/68, HR 102, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies show AST 3,200 IU/L, ALT 2,800 IU/L, and INR 1.1. She denies abdominal trauma or recent viral illness. Which mechanism best explains the hepatocellular injury in this patient?
Answer choices
- AAccumulation of a toxic metabolite that depletes glutathioneCorrect answer
- BAutoimmune destruction of bile ducts
- CDirect infection of hepatocytes by an RNA virus
- DCopper accumulation in hepatocytes and basal ganglia
- EIron deposition due to increased intestinal absorption
- FMitochondrial dysfunction due to inhibition of oxidative phosphorylation
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