General Medicine

20 learning units • 100 chapter sections • 200 explained questions. Assess the patient, choose investigations and build a monitored management plan across adult medical specialties.

Original RAHBAR study material for the Year 4 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 10 / 20

Jaundice & Decompensated Liver Disease

Interpret liver-test patterns and recognise complications that require urgent investigation and treatment.

Choose an answer and check it immediately. Change your choice to try again. This is a self-study exercise; results are not saved.

Question 01. Predominant alkaline-phosphatase elevation suggests which pattern? A. Purely isolated haemolysis in every caseB. A normal liver profileC. CholestaticD. Primary respiratory acidosis

Question 02. What do aminotransferases mainly indicate? A. Hepatocellular injuryB. Exact liver functional reserveC. Portal pressure directlyD. The presence of every gallstone

Question 03. Jaundice with new confusion and coagulopathy needs what? A. Routine repeat testing in six monthsB. Urgent specialist assessmentC. Reassurance based only on mild painD. An elective diet diary alone

Question 04. Which is a feature of decompensated cirrhosis? A. Stable isolated myopiaB. A healed ankle injuryC. Seasonal sneezing aloneD. Ascites

Question 05. Which can precipitate hepatic encephalopathy? A. Corrected vision aloneB. A normal sodium level aloneC. Gastrointestinal bleeding or infectionD. A remote healed fracture

Question 06. Can SBP occur without marked fever or abdominal pain? A. YesB. NoC. Only after surgeryD. Only without ascites

Question 07. An ascitic neutrophil count of 400 cells per microlitre raises concern for what? A. A guaranteed benign fluid sampleB. Spontaneous bacterial peritonitis in the appropriate settingC. Exclusion of infectionD. Isolated haemolysis

Question 08. What is a sensible first-line imaging approach for possible biliary obstruction? A. Routine brain EEGB. Limb nerve conduction testingC. Exercise ECG aloneD. Abdominal ultrasound

Question 09. Fever, jaundice and right-upper-quadrant pain suggest what urgent problem? A. Uncomplicated refluxB. Benign positional vertigoC. Isolated tension headacheD. Acute cholangitis

Question 10. Why review all medicines and supplements in jaundice? A. Supplements can never affect the liverB. Prescribed medicines exclude viral diseaseC. Drug-induced liver injury is possibleD. Medication history replaces examination

0 / 10 answeredReady for assessment →

References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

NICE NG50 — Cirrhosis

Reference review: 27 September 2026. Consult current local protocols for prescribing, procedures and escalation.