Hepatobiliary Disease USMLE Step 1 Practice Question
A 28-year-old woman with no significant past medical history presents to the emergency department with a 2-week history of progressive jaundice, fatigue, and abdominal discomfort. Three days ago, she developed confusion and asterixis. On examination, she appears acutely ill with jaundice and hepatomegaly. Laboratory studies show: total bilirubin 8.2 mg/dL, ALT 1,840 IU/L, AST 2,120 IU/L, alkaline phosphatase 180 IU/L, albumin 2.8 g/dL, PT/INR 4.1. Serologies are negative for hepatitis A, B, C, and EBV. Acetaminophen level is undetectable. Abdominal ultrasound shows normal hepatic vasculature with no biliary obstruction. Which of the following is the most likely diagnosis?
Answer choices
- AAcute hepatitis B infection with anti-HBc positivity
- BFulminant drug-induced liver injury from an unrecognized medication
- CAutoimmune hepatitisCorrect answer
- DWilson disease with acute hemolytic anemia
- EBudd-Chiari syndrome
- FAcute alcoholic hepatitis
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