Primary biliary cholangitis and primary sclerosing cholangitis Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 40-year-old woman comes to the clinic for evaluation of generalized fatigue and pruritus. Review of systems is otherwise unremarkable. She has no family history of liver disease. Past medical history is noncontributory and she does not take any medication. Vitals are within normal limits. Physical examination shows moist mucous membranes. Neck is supple. Lungs are clear to auscultation. No ascites or organomegaly is noted. Laboratory findings are shown below. Right upper quadrant ultrasound shows a normal appearing liver, gallbladder, and biliary tract. Antimitochondrial antibody titer is 1:80. Which of the following is the most appropriate next step in management?  

Laboratory value  
Result
Complete Blood Count  

Hemoglobin
12.5 g/dL
Leukocyte count  
5500/mm3   
Platelet Count  
200,000/mm3   
Serum Chemistry  

Sodium
142 mEq/L  
Potassium
4.2 mEq/L  
Chloride
95 mEq/L  
Creatinine
1.1 mg/dL  
Alanine aminotransferase  
20 U/L
Aspartate aminotransferase  
21 U/L
Serum albumin  
4 g/dL
Serum total bilirubin  
2.1 mg/dL
Total protein  
6 g/dL
Alkaline phosphatase level  
250 U/L

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