Published 18 March 2009, doi:10.1136/bmj.b1027
Cite this as: BMJ 2009;338:b1027

Endgames

On Examination quiz

Hepatobiliary system

The first 100% of the full text of this article appears below.

The answer to this question, and more questions on this topic, are available from www.onexamination.com/endgames until midnight on Wednesday.

This week’s quiz is on the hepatobiliary system and is taken from the MRCP Parts 1 and 2.

A 75 year old retired farmer from mid-Wales had mildly deranged liver function tests during a routine health check-up. He had an ultrasound scan, which showed multiple cystic lesions in the right lobe of the liver that ranged in size from 1 cm to 8 cm in diameter. The larger cysts had a calcified appearance.

A melanoma had been removed from his back 20 years ago, and multiple basal cell carcinomas had been removed from his head, face, and arms in recent years.

What investigation should be done next?

  • Computed tomography scan
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Hydatid serology
  • Laparoscopy
  • Ultrasound guided aspiration

Cite this as: BMJ 2009;338:b1027


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