Cirrhosis of the liver
Carcinoma head of pancreas
Common bile duct stones
Primary biliary cirrhosis
Primary sclerosing cholangitis
1) A 65-year-old male complains of yellow discolouration
of his eyes. He complains of passing dark urine and on direct questioning says
that his stools are pale. He has a poor appetite and has lost weight. He
denies any abdominal pain.
On examination he appears to have lost weight but there
are no other abnormalities.
2) A 24-year-old university student who has returned from
a backpacking holiday in India presents with fever, abdominal discomfort and
passage of dark urine of several days duration.
On examination his sclera is icteric, there is 3
fingerbreadths tender hepatomegaly.
3) A 55-year-old obese female presents with a history of
colicky right hypochondrial pain. The pain subsides but she notices yellow
discolouration of her eyes. On direct questioning she reveals that her urine
is dark in colour and her stools are pale.
She is a dinner lady at a school, married and has 5
On examination she is obese, has fever and is tender over
the right hypochondrium.
4) A 60-year-old male presents with yellow discolouration
of his eyes. He gives a history of altered bowel habit with alternating
constipation and loose motions of several months duration. Recently he has
noticed that he has passed some blood in his stool.
On examination he appears unwell, abdominal examination
reveals an enlarged liver that is hard in consistency and the surface of the
liver is irregular. A bruit is heard over it.
5) A 36-year-old male who is known to have ulcerative
colitis, which is well controlled on Asacol 800 mgs t.d.s. presents with
fever, abdominal pain, itching and yellow discolouration of his skin .
On examination he is febrile, jaundiced and has