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Acute hepatitis A — SCE Acute Medicine MCQ

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ModerateAcute GI PresentationsAcute hepatitis ASCE Acute Medicine

A 26-year-old man is assessed on the acute medical unit. He has fever, malaise, jaundice and very high ALT after travel. IgM anti-HAV is positive and INR is normal. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: B — Acute hepatitis A

Acute hepatitis A is the best answer because positive IgM anti-HAV with acute hepatitic illness supports acute hepatitis A. Aortic dissection is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Public health notification and hygiene advice are important.

Reference: UKHSA hepatitis A guidance