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USMLE-Rx Step 1 Qmax Challenge #1526

Check out today’s Step 1 Qmax Question Challenge.

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A 58-year-old man with a history of alcohol abuse presents to the hospital with a protuberant abdomen, slurring of speech, and confusion. On physical examination there are multiple spider angiomata on his chest, and a fluid wave is elicited on abdominal examination. When his hands are extended outward, a flapping tremor appears. He is promptly treated with medications to reduce the level of toxic metabolite responsible for his symptoms.

Normally, where do the initial steps for detoxification of this metabolite take place?

A. Hepatocyte cytoplasm
B. Hepatocyte endoplasmic reticulum
C. Hepatocyte mitochondria
D. Kupffer cell cytoplasm
E. Portal circulation

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