Deck 11: The Liver and Biliary System

Question 1

All the following are major functions of the liver except:

A) Excretory
B) Metabolic
C) Storage
D) Neuroendocrine
E) Synthetic

Answer 1

Neuroendocrine

Question 2

Unconjugated bilirubin circulates in the blood bound to:

A) Immunoglobulin G
B) Albumin
C) Haptoglobin
D) Transferrin
E) Ceruloplasmin

Answer 2

Albumin

Question 3

Which of the following hepatitis viruses is currently the most common cause of cirrhosis in the United States?

A) HAV
B) HBV
C) HCV
D) HDV
E) HEV

Answer 3

HCV

Question 4

In Wilson's disease the serum contains decreased amounts of:

A) Hemosiderin
B) Transferrin
C) Ferritin
D) Ceruloplasmin
E) Haptoglobin

Question 5

In hemochromatosis the liver contains increased amounts of:

A) Copper
B) Zinc
C) Iron
D) Selenium
E) Nickel

Question 6

The nutrients reach the liver from the intestine through the:

A) Splenic vein
B) Vena cava inferior
C) Vena cava superior
D) Portal vein
E) Hepatic vein

Question 7

In cirrhosis the surface of the liver is:

A) Smooth and shiny
B) Smooth but fatty
C) Dark brown and rough
D) Nodular
E) Covered with fibrin or pus

Question 8

Which immunologic finding is most typical of primary biliary cirrhosis?

A) Antinuclear antibodies
B) Antismooth muscle antibodies
C) Antimitochondrial antibodies
D) Antimicrosomal antibodies
E) Antinucleolar antibodies

Question 9

Which aspect of cirrhosis accounts for the development of esophageal varices?

A) Portal hypertension
B) Decreased level of fibrinogen in blood
C) Retention of sodium
D) Low osmolality of the plasma
E) Hypersplenism

Question 10

The most common malignant tumor of the liver is:

A) Hepatocellular carcinoma
B) Cholangiocellular carcinoma
C) Kupffer cell sarcoma
D) Carcinoid
E) Metastatic tumor from another site

Question 11

In chronic liver failure there is a marked decrease of blood:

A) Hemoglobin
B) Bilirubin
C) Immunoglobulin G
D) Immunoglobulin M
E) Albumin

Question 12

The lack of bile adversely affects the absorption of all the following vitamins except:

A) Vitamin A
B) Vitamin B₁2
C) Vitamin K
D) Vitamin D
E) Vitamin B

Question 13

Complications of cirrhosis include all the following except:

A) Ascites
B) Splenomegaly
C) Esophageal varices
D) Hypoalbuminemia
E) Hypogammaglobulinemia

Question 14

Primary sclerosing cholangitis affects primarily:

A) Intercellular bile ductules along the liver cell plates
B) Small intrahepatic bile ductules
C) Small intrahepatic bile ducts
D) Extrahepatic bile ducts
E) Gallbladder

Question 15

Which of the following serum enzymes is the most reliable marker of extrahepatic biliary obstruction?

A) Alanine aminotransferase
B) Aspartate aminotransferase
C) Creatine kinase
D) Amylase
E) Alkaline phosphatase

Question 16

Unconjugated hyperbilirubinemia is indicative of:

A) Hemolytic jaundice
B) Viral hepatitis
C) Drug-induced hepatitis
D) Hepatic tumor
E) Extrahepatic biliary obstruction

Question 17

Accumulation of fluid in the abdominal cavity in patients with cirrhosis is associated with hypersecretion of which hormone?

A) Insulin
B) Glucagon
C) Corticosteroids
D) Aldosterone
E) Androgen

Question 18

Which of the following is the most common cause of cirrhosis in childhood?

A) Hepatitis A virus infection
B) Hepatitis D virus infection
C) Hemosiderosis
D) Alpha1-antitrypsin deficiency
E) Wilson's disease

Question 19

Overall,the most common cause of cirrhosis in the United States is:

A) Viral infection
B) Alcohol abuse
C) Drug abuse
D) Immune hepatitis
E) Extrahepatic obstruction

Question 20

Which of the following hepatitis viruses is a DNA virus with a protein envelope that contains several distinct antigens,such as surface antigen?

A) HAV
B) HBV
C) HCV
D) HDV
E) HEV

Question 21

In the preantibiotic era the most common cause of pylephlebitic abscesses of the liver was:

A) Peptic ulcer
B) Crohn's disease
C) Ulcerative colitis
D) Acute appendicitis
E) Intestinal tuberculosis

Question 22

Gallbladder carcinoma is:

A) More common in females than in males
B) More often squamous than adenocarcinoma
C) More often invading the intestine than the liver
D) More common in young people than in old people
E) More often accompanied by jaundice than carcinoma of the common bile duct

Question 23

Yellow cholesterol gallstones are typically found in association with:

A) Hemochromatosis
B) Viral hepatitis
C) Sickle cell anemia
D) Chronic autoimmune hemolytic anemia
E) Obesity

Question 24

Which of the following is a good serologic marker of hepatocellular carcinoma?

A) Bilirubin
B) Human chorionic gonadotropin
C) Alpha-fetoprotein
D) Alpha1-antitrypsin
E) Alkaline phosphatase