skip to main content

Severe alcoholic hepatitis — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute GI PresentationsSevere alcoholic hepatitisSCE Acute Medicine

A 46-year-old man is assessed on the acute medical unit. He has jaundice after heavy alcohol use, tender hepatomegaly, fever and AST greater than ALT but both under 500 IU/L. INR is prolonged. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Severe alcoholic hepatitis

Severe alcoholic hepatitis is the best answer because the pattern of jaundice, systemic inflammation and AST-predominant transaminitis after heavy alcohol use suggests alcoholic hepatitis. Anaphylaxis 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: Severity scores guide steroid consideration after infection is assessed.

Reference: BSG alcohol-related liver disease guidance