Deck 37: Liver Disease

Question 1

The type of RNA virus that is considered to be the cause of the most common type of acute hepatitis that does not lead to chronic hepatitis is:

A) hepatitis A virus.
B) hepatitis B virus.
C) hepatitis C virus.
D) Reye syndrome.

Answer 1

hepatitis A virus.

Question 2

A 30-year-old man sees his physician with complaints of pruritus,fever,and pain around his abdomen and right side that he says "have been there a while but suddenly got really bad." Laboratory results on his blood sample indicate elevated conjugated and unconjugated bilirubin and elevated alkaline phosphatase activity.There are no signs of chronic hepatitis or ascites.Gallstones are ruled out,and the physician notes that a previous diagnosis of ulcerative colitis had been made.What is the likely current diagnosis?

A) Primary sclerosing cholangitis
B) Acute hepatitis attack from fulminant hepatitis
C) Hemolytic anemia caused by tumor
D) Liver injury caused by obstruction of the portal vein

Answer 2

Primary sclerosing cholangitis

Question 3

A new intern calls the laboratory to ask which liver enzymes would be best to assess to differentiate between hepatocellular and cholestatic disease.You respond:

A) ALP,GGT,and LD.
B) AST,ALT,and ALP.
C) ALP and GGT only.
D) AST and ALT only.

Answer 3

AST,ALT,and ALP.

Question 4

In chronic liver failure,such as cirrhosis,there is a significant impairment of normal ammonia metabolism and eventual hyperammonemia.Elevated ammonia can lead to:

A) hepatocellular carcinoma.
B) hepatic encephalopathy.
C) chronic hepatitis.
D) cholestasis.

Question 5

Which one of the following is considered a mechanism by which a membrane-bound enzyme,such as alkaline phosphatase,is released from a hepatocyte into blood?

A) Bile acids solubilize membrane-bound enzymes.
B) Cell injury allows leakage of the enzyme into blood.
C) Decreased expression of the enzyme causes release from the membrane.
D) Alcohol fragments membranes and causes release of the membrane-bound enzyme.

Question 6

In the liver,ammonia is metabolized to form:

A) amino acids.
B) ketoacids.
C) urea.
D) glucuronic acid.

Question 7

Which one of the following is not a consequence of portal hypertension in an individual?

A) Bleeding esophageal varices
B) Increased prothrombin time
C) Altered estrogen metabolism
D) Hemochromatosis

Question 8

Bilirubin that is attached to albumin before it is transported across the hepatocyte membrane is called:

A) unconjugated bilirubin.
B) conjugated bilirubin.
C) jaundice.
D) urobilinogen.

Question 9

Prognosis in cirrhosis is based on a MELD score,which is also used to prioritize cases for liver transplantation.Which of the following laboratory values are used to calculate the MELD score of an individual?

A) Plasma albumin,bilirubin,and liver enzymes
B) Liver enzyme activities and prothrombin time
C) Bilirubin,creatinine,and INR
D) Creatinine,urea,and ammonia

Question 10

The functional unit of the liver is the:

A) nephron.
B) cord.
C) glomerulus.
D) acinus.

Question 11

An autoimmune disease caused by an antibody directed toward the mitochondria of biliary epithelial cells that results in hepatic inflammation and portal hypertension is:

A) autoimmune hepatitis.
B) fatty liver.
C) fulminant hepatitis.
D) primary biliary cirrhosis.

Question 12

MATCHING
Match the disorder with the correct cause of that condition.
Cirrhosis

A)Decreased flow of bile
B)Inflammation of bile ducts
C)Gallstones in bile ducts
D)Fibrosis of the liver

Question 13

The major risk factor for development of hepatocellular carcinoma is:

A) infection with hepatitis A virus.
B) infection with hepatitis B or C viruses.
C) hepatorenal syndrome.
D) hepatic encephalopathy.

Question 14

The first protein marker to appear approximately 1 to 2 months after infection with the hepatitis B virus and also the last marker to disappear is the:

A) antihepatitis B core antigen.
B) antihepatitis B surface antigen.
C) hepatitis B surface antigen.
D) hepatitis B immune globulin.

Question 15

MATCHING
Match the disorder with the correct cause of that condition.
Cholestasis

A)Decreased flow of bile
B)Inflammation of bile ducts
C)Gallstones in bile ducts
D)Fibrosis of the liver

Question 16

Which type of hepatitis is a leading cause of chronic hepatitis and is caused by a mutating RNA virus?

A) Hepatitis A
B) Fulminant hepatitis
C) Hepatitis B
D) Hepatitis C

Question 17

Liver disease is classified as either acute or chronic.Acute liver disease takes the general form of either acute hepatitis or:

A) cirrhosis.
B) cholestasis.
C) hepatocellular carcinoma.
D) portal hypertension.

Question 18

MATCHING
Match the disorder with the correct cause of that condition.
Choledocholithiasis

A)Decreased flow of bile
B)Inflammation of bile ducts
C)Gallstones in bile ducts
D)Fibrosis of the liver

Question 19

A 53-year-old man notices the whites of his eyes seem a bit yellow,there is swelling in his abdomen,and he is often fatigued.He tells his physician that he enjoys "a few" martinis every night and sometimes more on the weekend.Upon physical examination,the physician notes decreased weight,elevated blood pressure,jaundice,and ascites,and laboratory results indicate decreased albumin,low platelet count,increased prothrombin time,and increased serum liver enzymes with AST activity higher than ALT.All viral hepatitis and cholestasis testing is negative.What is the likely diagnosis?

A) Pancreatitis
B) Primary sclerosing cholangitis
C) Chronic alcoholic hepatitis transitioning to cirrhosis
D) Nonalcoholic fatty liver disease

Question 20

You operate a laboratory that receives many serum specimens from the Billy Rubin Memorial Liver Clinic next door.The patients who go to this clinic have serious acute and chronic liver diseases.Would you expect to see increased or decreased plasma albumin from the liver patients who go to this clinic?

A) Increased
B) Decreased

Question 21

Alkaline phosphatase is a soluble enzyme localized in the cytosol of hepatocytes.

Question 22

MATCHING
Match the disorder with the correct cause of that condition.
Cholangitis

A)Decreased flow of bile
B)Inflammation of bile ducts
C)Gallstones in bile ducts
D)Fibrosis of the liver

Question 23

The most common cause of toxic hepatitis in North America leading to direct damage of hepatocytes is acetaminophen overdose.