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hepatitis B

Practice targeted AMC-style multiple-choice questions on hepatitis B.

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gastroenterologycirrhosisoncologyabdominal swellinghepatitis Cliver diseaseabdominal painascitesbiopsyelderly patient
Contrast-enhanced ultrasound of encephaloid hepatocellular carcinoma
Image by R. Badea, Simona Ioanitescu — CC BY 3.0 · Source

A 62-year-old male with cirrhosis presents for routine surveillance. AFP is elevated. The provided image was obtained. What is the MOST appropriate next step in management?

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A 55-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and abdominal discomfort. He has a history of chronic hepatitis B infection. On examination, he has mild hepatomegaly and jaundice. Blood tests reveal elevated liver enzymes and alpha-fetoprotein levels. An ultrasound of the abdomen shows a 3 cm lesion in the right lobe of the liver. What is the most likely diagnosis?

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CT scan of hepatocellular carcinoma, without and with IV contrast
Image by Zhenyu Pan, Guozi Yang, Tingting Yuan, Lihua Dong, Lihua Dong — CC BY 4.0 · Source

A 65-year-old male with known cirrhosis secondary to chronic hepatitis B presents with increasing abdominal distension and fatigue. He has mild ascites. Liver function tests show bilirubin 35 umol/L, INR 1.3, albumin 30 g/L. AFP is 850 ng/mL. Imaging is performed as shown. Based on the imaging findings and clinical presentation, which of the following treatment modalities is MOST likely to be considered for this patient?

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CT scan of hepatocellular carcinoma, without and with IV contrast
Image by Zhenyu Pan, Guozi Yang, Tingting Yuan, Lihua Dong, Lihua Dong — CC BY 4.0 · Source

A 62-year-old male with cirrhosis presents for routine surveillance. His AFP is elevated at 450 ng/mL. The provided image was obtained. What is the MOST appropriate next step in management?

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