Professional and Linguistic Assessments Board (PLAB) Practice Exam

What condition is typically characterized by cholestasis and portal hypertension in females?

1. Liver cirrhosis

2. Primary biliary cirrhosis

3. Cholecystitis

4. Fatty liver disease

The correct answer is: Primary biliary cirrhosis

Primary biliary cirrhosis is a chronic autoimmune liver disease that primarily affects women and is characterized by the progressive destruction of the bile ducts within the liver. This destruction leads to cholestasis, which is the accumulation of bile in the liver due to impaired bile flow. Over time, this condition can cause further liver damage and fibrosis, ultimately resulting in portal hypertension, a condition where the blood pressure in the liver's portal vein increases due to insufficient blood flow through the liver. Unlike liver cirrhosis, which can stem from a variety of causes including alcohol use and viral hepatitis, primary biliary cirrhosis has a distinct pathophysiology linked to the immune-mediated attack on bile ducts. Cholecystitis, on the other hand, involves inflammation of the gallbladder, which does not typically lead to cholestasis or portal hypertension as primary biliary cirrhosis does. Fatty liver disease is related to the accumulation of fat in liver cells and does not directly involve the bile ducts or cause cholestasis in the same manner as primary biliary cirrhosis. Thus, the combination of cholestasis and portal hypertension specifically points to primary biliary cirrhosis, making it the correct choice