[MCQ] Approach to liver disease- Part 2

I. Start the exam by click the “Start” button

Approach to liver disease- Part 2

Please wait while the activity loads.
If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.

If loading fails, click here to try again

Start

Congratulations - you have completed Approach to liver disease- Part 2. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

Which of the following is an inherited liver disease ?

A	Wilson’s disease
B	Hemochromatosis
C	α1 antitrypsin (1AT) deficiency
D	All of the above

Question 2

Which of the following is an inherited pediatric liver disease ?

A	Familial intrahepatic cholestasis
B	Benign recurrent intrahepatic cholestasis
C	Alagille syndrome
D	All of the above

Question 3

Which of the following statements is false ?

A	Muscle wasting is a sign of advanced liver disease
B	Palmar erythema occur in acute liver disease
C	Jaundice may be detectable with S. bilirubin <2.5 mg/dL
D	None of the above

Question 3 Explanation:

Signs of advanced liver disease include muscle wasting, ascites, edema, bruising, dilated abdominal veins, hepatic fetor, asterixis, mental confusion, stupor, and coma. During recovery phase, jaundice may be detectable with S. bilirubin <2.5 mg/dL. Spider angiomata & palmar erythema occur in both acute & chronic liver disease

Question 4

Which of the following about spider angiomata is false ?

A	Occur in acute & chronic liver disease
B	Occur during pregnancy
C	Occur only on arms, face & upper torso
D	None of the above

Question 4 Explanation:

Spider angiomata occur only on the arms, face, and upper torso. Spider angiomata and palmar erythema occur in both acute and chronic liver disease and are prominent in cirrhosis, but they can occur in normal individuals and are frequently present during pregnancy

Question 5

The nature of vessel involved in spider angiomata is ?

A	Artery
B	Arteriole
C	Vein
D	Capillary

Question 5 Explanation:

Spider angiomata are superficial, tortuous arterioles & fill from center outwards & can be pulsatile.

Question 6

Most reliable physical finding in examining the liver is ?

A	Size
B	Shape
C	Tenderness
D	Liver edge

Question 6 Explanation:

Most reliable physical finding in examining the liver is hepatic tenderness.

Question 7

Which of the following is a test of mental status in hepatic encephalopathy ?

A	Trail-making test
B	Comparison of signatures
C	Drawing abstract objects
D	All of the above

Question 7 Explanation:

Mental status examination for hepatic encephalopathy include trail-making test, drawing abstract objects or comparison of a signature to previous ones.

Question 8

Which of the following is false about trail-making test ?

A	Series of 10 numbered circles
B	Normal time for connect-the-dot test is 15-30 seconds
C	Considerable delay means early hepatic encephalopathy
D	None of the above

Question 8 Explanation:

Mental status examination by trail-making test consists of a series of 25 numbered circles that the patient is asked to connect as rapidly as possible using a pencil. Normal range for connect-the-dot test is 15-30 seconds. Delay means early hepatic encephalopathy

Question 9

Which of the following is not a feature of hepatopulmonary syndrome ?

A	Hypoxemia
B	Pulmonary arteriovenous shunting
C	Orthodeoxia
D	Hypercarbia

Question 9 Explanation:

Hepatopulmonary syndrome is defined by the triad of liver disease, hypoxemia and pulmonary arteriovenous shunting. It is characterized by platypnea and orthodeoxia, representing shortness of breath and oxygen desaturation that occur upon assuming an upright position

Question 10

Slate-gray pigmentation to the skin also occurs with ?

A	Primary biliary cirrhosis
B	Sclerosing cholangitis
C	Xanthelasma
D	Hemochromatosis

Question 10 Explanation:

A slate-gray pigmentation of the skin occurs in hemochromatosis, if iron levels are high for a prolonged period

Question 11

Mucocutaneous vasculitis with palpable purpura is typical of ?

A	Primary biliary cirrhosis
B	Primary hepatocellular carcinoma
C	Cryoglobulinemia of chronic hepatitis C
D	Wilsons disease

Question 11 Explanation:

Mucocutaneous vasculitis with palpable purpura on lower extremities is typical of cryoglobulinemia of chronic hepatitis C.

Question 12

Kayser-Fleischer rings are a finding in ?

A	Primary biliary cirrhosis
B	Primary hepatocellular carcinoma
C	Wilson’s disease
D	Hemochromatosis

Question 12 Explanation:

Kayser-Fleischer rings occur in Wilson’s disease also called hepatolenticular degeneration/ WestphalStrumpell disease/Westphal pseudosclerosis. Bernhard Kayser and Bruno Fleischer were German ophthalmologists.

Question 13

Which of the following statements about Kayser-Fleischer ring is false ?

A	Found in 95% of patients of Wilson’s disease
B	All patients with KF rings have neurological manifestations
C	Density of a KF ring correlates with severity of Wilson’s disease
D	None of the above

Question 13 Explanation:

K-F-like ring has been reported in many other conditions like cryptogenic cirrhosis, chronic active hepatitis, neonatal hepatitis, primary biliary cirrhosis, cholestatic cirrhosis, hepatocellular disorders (when bilirubin rises acutely above 20mg/dl), alcoholic liver disease, galactosialidosis, schistosoma infection, multiple myeloma and intraocular foreign body containing copper.

Question 14

The colour of Kayser-Fleischer ring is ?

A	Yellow-red
B	Yellow-green
C	Golden-brown
D	Green-brown

Question 14 Explanation:

Kayser-Fleischer rings consist of a golden-brown copper pigment deposited in Descemet’s membrane at the periphery of the cornea - sclero-corneal junction. It may regress or disappear when systemic condition is well treated. It is usually bilateral & appears initially superiorly at 10 to 2 o’clock position, then inferiorly and later becomes circumferential.

Question 15

Wilson’s disease is due to defect in ?

A	ATP6B gene
B	ATP7B gene
C	ATP8B gene
D	ATP9B gene

Question 15 Explanation:

Wilson disease is an autosomal recessive disorder caused by mutations in the ATP7B gene, a membrane-bound copper-transporting ATPase. ATP7B facilitates the transfer of copper into Golgi apparatus where it combines with ceruloplasmin. Failure of this process leads to instability and decreased half life of ceruloplasmin and paradoxical ceruloplasmin deficiency. Free circulating copper accumulates in liver cytosol resulting in hepatocyte degeneration and cirrhosis. Other hepatic conditions as listed above that prevent elimination of copper, or intraocular foreign bodies containing copper, lead to elevated free copper concentrations and K-F ring.

Question 16

Wilson’s disease can produce a cataract described as ?

A	Christmas tree
B	Palm tree
C	Sunflower
D	Rose flower

Question 16 Explanation:

Sunflower cataracts & Kayser-Fleischer rings (copper deposits in the outer rim of cornea) are seen in Wilson’s disease

Question 17

Testing for P-ANCA is for the diagnosis of which of the following ?

A	Primary biliary cirrhosis
B	Primary sclerosing cholangitis
C	Autoimmune hepatitis
D	Nonalcoholic steatohepatitis

Question 18

Most common causes of chronic liver disease is ?

A	Chronic hepatitis C
B	Alcoholic liver disease
C	Chronic hepatitis B
D	Autoimmune hepatitis

Question 18 Explanation:

Most common causes of chronic liver disease in general order of frequency are chronic hepatitis C, alcoholic liver disease, nonalcoholic steatohepatitis, chronic hepatitis B, autoimmune hepatitis, sclerosing cholangitis, primary biliary cirrhosis, hemochromatosis, and Wilson disease.

Question 19

ERCP is more valuable in evaluating which of the following ?

A	Pancreatitis
B	Primary sclerosing cholangitis
C	Choledocholithiasis
D	Fatty liver

Question 19 Explanation:

ERCP is more valuable in evaluating ampullary lesions and primary sclerosing cholangitis

Question 20

Which of the following is often the first indication of worsening fibrosis in liver cirrhosis ?

A	Mild elevations of bilirubin
B	Mild elevations of bilirubin
C	Slight decreases in serum albumin
D	Mild thrombocytopenia

Question 20 Explanation:

Noninvasive tests that suggest advanced liver fibrosis include mild elevations of bilirubin, prolongation of prothrombin time, slight decreases in serum albumin, and mild thrombocytopenia (which is often the first indication of worsening fibrosis).

Question 21

Which of the following is not a factor in Child-Pugh classification of cirrhosis liver ?

A	Serum bilirubin
B	SGPT
C	Ascites
D	Hepatic encephalopathy

Question 21 Explanation:

Factors included in Child-Pugh classification of cirrhosis liver are serum bilirubin, serum albumin, prothrombin time, ascites & hepatic encephalopathy.

Question 22

Child-Pugh score can predict which of the following ?

A	Bleeding from varices
B	Spontaneous bacterial peritonitis
C	Need for liver transplantation
D	All of the above

Question 22 Explanation:

Child-Pugh score is a reliable predictor of bleeding from varices, spontaneous bacterial peritonitis and need for liver transplantation.

Question 23

Decompensation indicates cirrhosis with a Child-Pugh score of ?

A	4
B	5
C	6
D	7

Question 24

MELD score is used for ?

A	Assessing bleeding from varices
B	Assessing hepatocellular carcinoma
C	Assessing spontaneous bacterial peritonitis
D	Assessing need for liver transplantation

Question 24 Explanation:

Model for end-stage liver disease (MELD) score is used for assessing the need for liver transplantation.

Question 25

Variables for calculation of MELD score include all except ?

A	Prothrombin time
B	Serum bilirubin
C	B. urea
D	Serum creatinine

Question 25 Explanation:

MELD score is a prospectively derived scoring system calculated using three noninvasive variables - prothrombin time (INR), serum bilirubin and serum creatinine

Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results

There are 25 questions to complete.

←

List

→

Return

Shaded items are complete.

1	2	3	4	5
6	7	8	9	10
11	12	13	14	15
16	17	18	19	20
21	22	23	24	25
End

Return

See all quizzes of Peptic Ulcer Disease at here:

Approach to liver disease- Part 1| Approach to liver disease- Part 2

1. Which of the following is an inherited liver disease ?
A. Wilson’s disease
B. Hemochromatosis
C. 1 antitrypsin (1AT) deficiency
D. All of the above
2. Which of the following is an inherited pediatric liver disease ?
A. Familial intrahepatic cholestasis
B. Benign recurrent intrahepatic cholestasis
C. Alagille syndrome
D. All of the above
3.Which of the following statements is false ?
A. Muscle wasting is a sign of advanced liver disease
B. Palmar erythema occur in acute liver disease
C. Jaundice may be detectable with S. bilirubin <2.5 mg/dL
D. None of the above

4. Which of the following about spider angiomata is false ?
A. Occur in acute & chronic liver disease
B. Occur during pregnancy
C. Occur only on arms, face & upper torso
D. None of the above

5. The nature of vessel involved in spider angiomata is ?
A. Artery
B. Arteriole
C. Vein
D. Capillary

6. Most reliable physical finding in examining the liver is ?
A. Size
B. Shape
C. Tenderness
D. Liver edge

7. Which of the following is a test of mental status in hepatic
encephalopathy ?
A. Trail-making test
B. Comparison of signatures
C. Drawing abstract objects
D. All of the above

8. Which of the following is false about trail-making test ?
A. Series of 10 numbered circles
B. Normal time for connect-the-dot test is 15-30 seconds
C. Considerable delay means early hepatic encephalopathy
D. None of the above

9. Which of the following is not a feature of hepatopulmonary
syndrome ?
A. Hypoxemia
B. Pulmonary arteriovenous shunting
C. Orthodeoxia
D. Hypercarbia

10. Slate-gray pigmentation to the skin also occurs with ?
A. Primary biliary cirrhosis
B. Sclerosing cholangitis
C. Xanthelasma
D. Hemochromatosis

11. Mucocutaneous vasculitis with palpable purpura is typical of ?
A. Primary biliary cirrhosis
B. Primary hepatocellular carcinoma
C. Cryoglobulinemia of chronic hepatitis C
D. Wilsons disease

12. Kayser-Fleischer rings are a finding in ?
A. Primary biliary cirrhosis
B. Primary hepatocellular carcinoma
C. Wilson’s disease
D. Hemochromatosis

13.Which of the following statements about Kayser-Fleischer ring
is false ?
Br J Ophthalmol 2002;86:114
A. Found in 95% of patients of Wilson’s disease
B. All patients with KF rings have neurological manifestations
C. Density of a KF ring correlates with severity of Wilson’s
disease
D. None of the above

14. The colour of Kayser-Fleischer ring is ?
A. Yellow-red
B. Yellow-green
C. Golden-brown
D. Green-brown

15. Wilson’s disease is due to defect in ?
A. ATP6B gene
B. ATP7B gene
C. ATP8B gene
D. ATP9B gene

16. Wilson’s disease can produce a cataract described as ?
A. Christmas tree

B. Palm tree
C. Sunflower
D. Rose flower

17. Testing for P-ANCA is for the diagnosis of which of the
following ?
A. Primary biliary cirrhosis
B. Primary sclerosing cholangitis
C. Autoimmune hepatitis
D. Nonalcoholic steatohepatitis
18. Most common causes of chronic liver disease is ?
A. Chronic hepatitis C
B. Alcoholic liver disease
C. Chronic hepatitis B
D. Autoimmune hepatitis

19. ERCP is more valuable in evaluating which of the following ?
A. Pancreatitis
B. Primary sclerosing cholangitis
C. Choledocholithiasis
D. Fatty liver
20 Which of the following is often the first indication of worsening
fibrosis in liver cirrhosis ?
A. Mild elevations of bilirubin
B. Prolongation of prothrombin time
C. Slight decreases in serum albumin
D. Mild thrombocytopenia

21. Which of the following is not a factor in Child-Pugh
classification of cirrhosis liver ?
A. Serum bilirubin
B. SGPT
C. Ascites
D. Hepatic encephalopathy

22. Child-Pugh score can predict which of the following ?
A. Bleeding from varices
B. Spontaneous bacterial peritonitis

C. Need for liver transplantation
D. All of the above

23. Decompensation indicates cirrhosis with a Child-Pugh score of ?
A. 4
B. 5
C. 6
D. 7

24. MELD score is used for ?
A. Assessing bleeding from varices
B. Assessing hepatocellular carcinoma
C. Assessing spontaneous bacterial peritonitis
D. Assessing need for liver transplantation

25. Variables for calculation of MELD score include all except ?
A. Prothrombin time
B. Serum bilirubin
C. B. urea
D. Serum creatinine

26. System similar to MELD used for children below the age of 12
is termed ?
A. CELD
B. SELD
C. PELD
D. KELD

Approach to liver disease

[MCQ] Approach to liver disease- Part 2

I. Start the exam by click the “Start” button

Approach to liver disease- Part 2

Share this:

Related

[MCQ] Approach to liver disease- Part 1

[MCQ] Evaluation of liver function- Part 1

You may also like

Leave a Comment Cancel Reply