Question 1

An infusion of mannitol would be prescribed to treat&#10;A) varices.&#10;B) encephalopathy.&#10;C) peritonitis.&#10;D) cerebral edema.

Accepted Answer

Cerebral edema is managed primarily by the intravenous infusion of mannitol,which by increasing serum osmolarity draws water from the brain and thus reduces the swelling.Octreotide acetate is used in the management of varices.Hepatic encephalopathy would be treated with lactulose.Peritonitis is managed with the use of antimicrobial agents.

Question 2

An increased urine bilirubin is associated with&#10;A) an increased indirect serum bilirubin.&#10;B) hemolytic reactions.&#10;C) Gilbert syndrome.&#10;D) hepatitis.

Accepted Answer

In the presence of liver disease,the hepatic fraction of bilirubin decreases and the urinary fraction increases,thus accounting for a rise in urinary urobilinogen seen with liver dysfunction and hepatitis.An increase in indirect serum bilirubin is a sign of liver disease.Hemolytic reactions do not cause an increase in urine bilirubin.Disorders of the bile acid transport will cause an increase in serum bilirubin.

Question 3

A patient being treated for hepatic encephalopathy could be expected to receive a(n)________ diet.&#10;A) low-protein and high-fiber&#10;B) high-protein and high-carbohydrate&#10;C) high-sodium&#10;D) unrestricted

Accepted Answer

Restriction of protein is indicated for chronic encephalopathy,along with enhanced elimination of toxic nitrogenous substances.High fiber intake may help decrease constipation.As ammonia levels drop,protein is reintroduced into the diet.When protein is restricted,carbohydrate levels should be at least 400 g.Excessive levels of sodium in the diet are contraindicated with renal insufficiency.Dietary restrictions are utilized in patients with hepatic encephalopathy.

Question 4

A patient with a history of alcoholism presents with hematemesis and profound anemia.The expected diagnosis is&#10;A) ascites.&#10;B) cerebral edema.&#10;C) hepatic encephalopathy.&#10;D) gastroesophageal varices.

Accepted Answer

Esophageal varices primarily result from portal hypertension because of chronic alcoholism or hepatitis.Initial symptoms are bleeding,anemia,and shock.Ascites is an accumulation of fluid in the abdominal cavity.Cerebral edema is swelling of the brain related to hepatic encephalopathy.Hepatic encephalopathy does not cause symptoms related to bleeding.

Question 5

The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis.&#10;A) hemolysis&#10;B) metabolism&#10;C) fibrosis&#10;D) canalicular bilirubin transport

Accepted Answer

The most common causes of prehepatic jaundice are hemolysis and ineffective erythropoiesis.The reabsorption of large hematomas in patients with mild liver disease is a frequent and harmless cause of mild jaundice.Dysfunction of each of the hepatic steps in bilirubin metabolism may cause jaundice.Increased resistance from fibrosis may cause jaundice in the cholestatic pathway.At the canalicular posthepatocytic level,jaundice may occur as a result of conjugated hyperbilirubinemia.

Question 6

Hepatitis B is usually transmitted by exposure to&#10;A) hepatitis vaccine.&#10;B) feces.&#10;C) blood or semen.&#10;D) contaminated food.

Accepted Answer

Hepatitis B virus is highly prevalent worldwide.It is spread by parenteral contact with infected blood or blood products,including contaminated needles.HBV vaccine is a recombinant vaccine that is highly immunogenic.After the full course,the antibody response rate is 95% for normal hosts.Hepatitis A is spread by the fecal-oral route.Hepatitis E is spread through contaminated water.

Question 7

________ disease is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver.&#10;A) Kayser-Fleischer&#10;B) Wilson&#10;C) Reye&#10;D) Byler

Accepted Answer

Wilson disease,or hepatolenticular degeneration,is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver and other organs.As with hereditary hemochromatosis,it has now been linked to a specific abnormal protein,ATP7B,which results in retention of copper in the liver.Clinical signs and symptoms of Wilson disease include the presence of Kayser-Fleischer rings on the cornea.Reye syndrome is characterized by fatty infiltration of the liver with severe hepatic dysfunction,including encephalopathy,coagulopathy,and elevated levels of hepatocellular enzymes.Byler syndrome is caused by a single-gene mutation and traces back to an Amish kindred.

Question 8

Jaundice is a common manifestation of&#10;A) malabsorption syndromes.&#10;B) anemia.&#10;C) liver disease.&#10;D) cholecystitis.

Accepted Answer

Jaundice results from impaired bilirubin metabolism and is one of the most characteristic signs of liver disease.Malabsorption syndromes are not manifested by jaundice.Anemia is not manifested by jaundice.Jaundice is not a common manifestation of cholecystitis.

Question 9

What form of viral hepatitis is likely to be transmitted sexually?&#10;A) Hepatitis A&#10;B) Hepatitis B&#10;C) Hepatitis C&#10;D) Hepatitis E

Accepted Answer

Hepatitis B is spread by parenteral contact with infected blood or blood products,including contaminated needles,and by sexual contact.Hepatitis A virus (HAV)is usually spread by the fecal-oral route.The mode of transmission of hepatitis C closely resembles that of HBV,although sexual and perinatal transmission is much less likely.The majority of infections were acquired through IV drug abuse.Hepatitis E is an RNA virus spread via the fecal-oral route,especially through contaminated water.

Question 10

Brain injury secondary to high serum bilirubin is called&#10;A) hepatic encephalopathy.&#10;B) hepatic meningitis.&#10;C) kernicterus.&#10;D) encephalitis.

Accepted Answer

Kernicterus refers to brain injury as a result of hyperbilirubinemia.It is a serious complication of the neonatal period,generally occurring in the setting of premature birth,neonatal jaundice,and especially hemolytic disease of the newborn.Hepatic encephalopathy is typically characterized by high ammonia levels in the blood.Meningitis is not associated with high serum bilirubin levels.Encephalitis may accompany viral hepatitis in children,but is not related to high serum bilirubin levels.

Question 11

What laboratory data would support a diagnosis of hemochromatosis?&#10;A) Deficient protease inhibitor&#10;B) Elevated ferritin&#10;C) Elevated urine copper&#10;D) Positive antinuclear antibody

Accepted Answer

The answer of What laboratory data would support a diagnosis...

Question 12

Hepatic encephalopathy is associated with&#10;A) hyperbilirubinemia.&#10;B) hyperuricemia.&#10;C) toxic effects of alcohol on brain cells.&#10;D) increased blood ammonia levels.

Accepted Answer

The answer of Hepatic encephalopathy is associated with&#10;A) hyperbilirubinemia.&#10;B) hyperuricemia.&#10;C)...

Question 13

Pathophysiologically,esophageal varices can be attributed to&#10;A) elevated bilirubin.&#10;B) diminished protein metabolism.&#10;C) fluid accumulation.&#10;D) portal hypertension.

Accepted Answer

The answer of Pathophysiologically,esophageal varices can be attributed to&#10;A) elevated...

Question 14

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of&#10;A) glucose.&#10;B) octreotide acetate.&#10;C) anticoagulants.&#10;D) proton pump inhibitors.

Accepted Answer

The answer of A patient admitted with bleeding related to...

Question 15

A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg)should be interpreted as ________ hepatitis B.&#10;A) recovered from&#10;B) immunity to&#10;C) chronic active&#10;D) acute

Accepted Answer

The answer of A viral hepatitis screen with positive hepatitis...

Question 16

Steatohepatitis is caused by an accumulation of ________ in the liver cells.&#10;A) fat&#10;B) bile&#10;C) acetaminophen&#10;D) ferritin

Accepted Answer

The answer of Steatohepatitis is caused by an accumulation of...

Question 17

Liver transaminase elevations in which aspartate aminotransferase (AST)is markedly greater than alanine aminotransferase (ALT)is characteristic of&#10;A) viral hepatitis.&#10;B) alcohol-induced injury.&#10;C) cirrhosis.&#10;D) acetaminophen toxicity.

Accepted Answer

The answer of Liver transaminase elevations in which aspartate aminotransferase...

Question 18

Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA)is&#10;A) hepatitis D.&#10;B) autoimmune hepatitis.&#10;C) hepatitis A.&#10;D) hepatitis B.

Accepted Answer

The answer of Hepatitis with the presence of autoantibodies and...

Deck 38: Liver Diseases