This page is dedicated to organizing various examples of standardized exam questions whose answer is primary sclerosing cholangitis. While this may seem a odd practice, it is useful to see multiple examples of how primary sclerosing cholangitis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 51 year old male comes to the clinic because he has had a 6 week history of generalized itching and also has noticed that his skin is yellow. This patient has a history of ulcerative colitis, Gilbert syndrome, osteoarthritis, and obsessive compulsive disorder. Currently he is taking fluoxetine and ibuprofen daily. He has a 40 pack year history of smoking and estimates that he has 3 alcoholic drinks daily. HIs vitals are as follows: temperature 98.7°F, pulse is 91/min, and blood pressure is 120/65 mm Hg. A physical exam shows scleral icterus and jaundice. There are numerous excoriations present over the back. An abdominal exam is unremarkable. Lab studies are as follows:
- Hemoglobin: 13.1 g/dL
- Leukocyte count: 8200/mm3
- Total bilirubin: 12.5 mg/dL
- Direct bilirubin: 10.1 mg/dL
- Alkaline phosphatase: 495 U/L
Endoscopic retrograde cholangiopancreatography is remarkable for narrowing of the biliary ducts. What is the likely diagnosis?
Page Updated: 01.22.2017