Deck 31: Liver Function

Question 1

Within the hepatocyte's cytoplasm, there is normally more AST than ALT by a factor of about ______; however, the amount of cytoplasmic ALT ______ with alcohol abuse, pyridoxine deficiency, and in cirrhosis, which ______ the cellular ratio of AST to ALT.

A)1.2, decreases, increases
B)1.5, increases, decreases
C)1.5, decreases, increases
D)1.2, increases, decreases

Answer 1

1.5, decreases, increases

Question 2

Laboratory findings in chronic Wilson's disease include ______ ceruloplasmin, ______ total plasma copper, ______ free plasma copper, and ______ urine copper.

A)increased, increased, decreased, decreased
B)decreased, decreased, decreased, decreased
C)increased, increased, decreased, increased
D)decreased, decreased, increased, increased

Answer 2

decreased, decreased, increased, increased

Question 3

The bile duct carries bile from the ______ to the ______, which when stimulated by cholecystokinin, contracts and releases bile through its duct, termed the ______.This joins the common hepatic duct to form the ______.

A)gall bladder, liver, common bile duct, cystic duct
B)liver, gall bladder, cystic duct, common bile duct
C)gall bladder, liver, cystic duct, common bile duct
D)liver, gall bladder, common bile duct, cystic duct

Answer 3

liver, gall bladder, cystic duct, common bile duct

Question 4

Which of the following syndromes has a mutation in the upstream promoter region of the gene for UDP-glucuronyl transferase 1 (UGT1) and results in reduced production of the enzyme?

A)Crigler-Najjar syndrome
B)Dubin-Johnson syndrome
C)Gilbert's syndrome
D)Wilson's disease

Question 5

Laboratory findings can be useful in following the progression of chronic hepatitis to cirrhosis.As this occurs, the platelet count will ______, the prothrombin time will ______, albumin will ______, and ALP will ______.

A)decrease, increase, decrease, increase
B)decrease, decrease, increase, increase
C)increase, decrease, increase, decrease
D)increase, increase, decrease, decrease

Question 6

Which of the following sets of screening tests and confirmatory tests would be best when diagnosing Wilson's disease?

A)screening tests: serum iron, iron-binding capacity, ferritin; confirmatory test: HFE gene analysis
B)screening tests: ANA, anti-smooth muscle; confirmatory test: liver biopsy
C)screening tests: serum iron, serum/urine copper; confirmatory test: HFE gene analysis, liver biopsy
D)screening test: ceruloplasmin, serum/urine copper; confirmatory test: liver biopsy; genetic studies

Question 7

The liver is supplied by what major source(s) of oxygen-containing blood?

A)the hepatic artery
B)the portal vein
C)the hepatic vein
D)both a and b

Question 8

When considering hemochromatosis, those with ferritin levels _____ almost never have liver damage, whereas the likelihood of progressive liver fibrosis is high if ferritin is ______.This can be managed by therapeutic phlebotomy of up to 1 unit of blood per week until serum ferritin is _____.

A)<300 ng/mL, >1000 ng/mL, <50 ng/mL
B)<50 ng/mL, >750 ng/mL, <300 ng/mL
C)<300 ng/mL, >750 ng/mL, <50 ng/mL
D)<50 ng/mL, >1000 ng/mL, <300 ng/mL

Question 9

Which of the following statements is true of jaundice?

A)Jaundice can be detected when serum bilirubin reaches 5 mg/L in adults and 10 mg/L in neonates.
B)Jaundice can be detected when serum bilirubin reaches 10 mg/L in adults and 20 mg/L in neonates.
C)Jaundice can be detected when serum bilirubin reaches 20 mg/L in adults and 40 mg/L in neonates.
D)Jaundice can be detected when serum bilirubin reaches 30 mg/L in adults and 50 mg/L in neonates.

Question 10

Which of the following are true of ALP?
1)Increased ALP of liver origin is usually an indication of obstruction of biliary drainage.
2)ALP is a sensitive marker of obstructive disease secondary to tumors.
3)ALP is normally released into plasma with hepatocytes injury.

A)1, 2, 3
B)1, 2
C)2, 3
D)1, 2.

Question 11

All of the following are common causes of acute hepatitis except:

A)non-alcoholic fatty liver disease (NAFLD)
B)hepatitis A virus (HAV)
C)hepatitis B virus (HBC)
D)hepatitis C virus (HCV)

Question 12

Which of the following functions are performed by hepatocytes?
1)metabolism
2)synthesis of critical components
3)formation of bile
4)endocrine functions

A)1, 2, 3, 4
B)1, 2, 4
C)1, 3, 4
D)2, 3, 4

Question 13

Autoimmune hepatitis:
1)is characterized by increased immunoglobulin production.
2)is characterized by the presence of autoantibodies.
3)leads to rapid progression of cirrhosis if untreated.
4)is associated with iron accumulation in parenchymal organs.

A)1, 2, 3, 4
B)1, 2, 3
C)1, 2, 4
D)2, 3, 4

Question 14

The liver:
1)is the primary organ responsible for the metabolism of carbohydrates, proteins, lipids, porphyrins, and bile acids.
2)is responsible for synthesizing immunoglobulins.
3)is the principal site for storage of iron.
4)is the principal storage site of lipids and vitamins.

A)1, 2, 3, 4
B)1, 3, 4
C)1, 2, 3
D)1, 2, 4

Question 15

Select the cause for liver disease indicated by the laboratory data provided below.
AST - slightly above the upper reference limit (URL)
ALT - slightly above URL
AST/ALT ratio - less than 1
GGT - three times URL
ALP - normal

A)acute viral hepatitis
B)drug-induced hepatitis
C)cirrhosis
D)autoimmune liver disease

Question 16

Warfarin blocks the activation of what clotting factors?
1)II
2)VII
3)IX
4)X

A)1, 2, 3, 4
B)1, 2, 3
C)1, 2, 4
D)1, 3, 4

Question 17

In hemolytic jaundice, urine urobilinogen will be ______, urine bilirubin will be ______, and the predominate form of bilirubin in the blood stream will be ______.

A)increased, detectable, conjugated
B)increased, not detectable, unconjugated
C)decreased, detectable, unconjugated
D)decreased, not detectable, conjugated