Hepatobiliary Disease USMLE Step 1 Practice Question
A 34-year-old woman with Wilson disease presents with acute liver failure, hemolytic anemia, and tremor. Vital signs show BP 92/58, HR 118, RR 22, temperature 37.2°C, SpO2 98% on room air. Laboratory studies reveal undetectable serum ceruloplasmin, massively elevated urinary copper excretion, INR 4.2, and hemoglobin 7.8 g/dL. She denies abdominal pain. The patient is neurologically unstable. Which of the following is the most appropriate urgent intervention?
Answer choices
- ASupportive care with corticosteroids
- BPenicillamine initiation with zinc supplementation
- CUrgent liver transplantationCorrect answer
- DPlasmapheresis for copper removal
- EChelation therapy with deferasirox
- FHemodialysis with copper-specific hemofiltration cartridges
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.