[MCQ] Cirrhosis- Part 1

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Cirrhosis- Part 1

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Question 1

Reversal of fibrosis in cirrhosis liver can be achieved with treatment in which of the following diseases ?

A	Chronic hepatitis C
B	Hemochromatosis
C	Alcoholic liver disease
D	All of the above

Question 1 Explanation:

Upon successful treatment of chronic hepatitis C, hemochromatosis and alcoholic liver disease liver fibrosis can be reversed

Question 2

The cardinal pathologic features of cirrhosis liver are ?

A	Irreversible chronic injury of hepatic parenchyma
B	Extensive fibrosis
C	Formation of regenerative nodules
D	All of the above

Question 2 Explanation:

The cardinal pathologic features reflect irreversible chronic injury of the hepatic parenchyma and include extensive fibrosis in association with the formation of regenerative nodules

Question 3

The pathologic features of cirrhosis liver result from ?

A	Hepatocyte necrosis
B	Destruction of the supporting reticulin network
C	Distortion of the vascular bed
D	All of the above

Question 3 Explanation:

The pathologic features result from hepatocyte necrosis, collapse of the supporting reticulin network with subsequent connective tissue deposition, distortion of the vascular bed, and nodular regeneration of remaining liver parenchyma

Question 4

Central event leading to hepatic fibrosis in cirrhosis liver is ?

A	Activation of the hepatic stellate cell
B	Activation of the CD 8+ cells
C	Activation of Kupffer cells
D	All of the above

Question 5

In cirrhosis liver, activated hepatic stellate cells transform into ?

A	Elastic tissue
B	Lymphoid tissue
C	Myofibroblasts
D	Hepatocytes

Question 6

In cirrhosis liver, the stellate cell produces ?

A	Fibril-forming type I collagen
B	Fibril-forming type II collagen
C	Fibril-forming type III collagen
D	Fibril-forming type IV collagen

Question 7

In cirrhosis liver, which of the following leads hepatic stellate cells to produce collagen ?

A	TNF α
B	Insulin
C	Transforming growth factor β (TGF-β)
D	Erythropoietin

Question 7 Explanation:

Upon activation by factors released by hepatocytes and Kupffer cells, the stellate cell assumes a myofibroblast-like conformation and, under the influence of cytokines like transforming growth factor  (TGF-), produces fibril-forming type I collagen.

Question 8

Alcohol induced liver injury refers to ?

A	Cirrhosis liver
B	Alcoholic fatty liver
C	Alcoholic hepatitis
D	All of the above

Question 8 Explanation:

Alcohol-induced liver injury includes consequences resulting from chronic alcohol ingestion like alcoholic fatty liver, alcoholic hepatitis and alcoholic cirrhosis.

Question 9

Hepatic fibrosis secondary to chronic alcohol use is ?

A	Centrilobular
B	Pericellular
C	Periportal
D	Any of the above

Question 9 Explanation:

Chronic alcohol use can produce fibrosis in the absence of accompanying inflammation and/or necrosis. Fibrosis can be centrilobular, pericellular, or periportal

Question 10

The diameter of nodules in alcoholic cirrhosis is ?

A	< 0.5 mm
B	< 1 mm
C	< 2 mm
D	< 3 mm

Question 10 Explanation:

In alcoholic cirrhosis, nodules are usually <3 mm in diameter (micronodular). With cessation of alcohol use, larger nodules may form, resulting in a mixed micronodular and macronodular cirrhosis.

Question 11

Ethanol is mainly absorbed by ?

A	Stomach
B	Small intestine
C	Large intestine
D	All of the above

Question 11 Explanation:

Ethanol is mainly absorbed by small intestine and to a lesser degree through stomach

Question 12

Which of the following initiates alcohol metabolism ?

A	Cytosolic alcohol dehydrogenase (ADH)
B	Microsomal-oxidizing system (MEOS)
C	Peroxisomal catalase
D	Gastric alcohol dehydrogenase (ADH)

Question 12 Explanation:

Gastric alcohol dehydrogenase (ADH) initiates alcohol metabolism.

Question 13

Enzyme system for metabolism of alcohol in the liver is ?

A	Cytosolic alcohol dehydrogenase (ADH)
B	Microsomal ethanol oxidizing system (MEOS)
C	Peroxisomal catalase
D	All of the above

Question 13 Explanation:

Three enzyme systems metabolise alcohol in liver. These are cytosolic ADH, the microsomaloxidizing system (MEOS), and peroxisomal catalase

Question 14

Ethanol is oxidized to acetaldehyde by ?

A	Cytosolic alcohol dehydrogenase (ADH)
B	Microsomal-oxidizing system (MEOS)
C	Microsomal-oxidizing system (MEOS)
D	Gastric alcohol dehydrogenase (ADH)

Question 14 Explanation:

Majority of ethanol oxidation occurs via ADH to form acetaldehyde.

Question 15

Which out of the following is a highly reactive molecule ?

A	Alcohol
B	Acetaldehyde
C	Acetate
D	All of the above

Question 15 Explanation:

Ethanol oxidation occurs via ADH to form acetaldehyde which is metabolized to acetate by aldehyde dehydrogenase (ALDH). Acetaldehyde combines with proteins to form protein-acetaldehyde adducts that lead to hepatocyte damage like interference with specific enzyme activities (microtubular formation & hepatic protein trafficking), Kupffer cell activation. As a result, profibrogenic cytokines are produced that initiate and perpetuate stellate cell activation, with the resultant production of excess collagen and extracellular matrix

Question 16

In alcoholic cirrhosis, clinical findings include ?

A	Palmar erythema
B	Spider angiomas
C	Lacrimal gland enlargement
D	All of the above

Question 17

In alcoholic cirrhosis, clinical findings include all except ?

A	Clubbing of fingers
B	Muscle wasting
C	Signs of virilization in women
D	Xanthoma

Question 18

Which of the following findings are associated with alcoholism but are not specifically related to cirrhosis ?

A	Palmar erythema
B	Spider angiomas
C	Gynecomastia
D	Dupuytren’s contractures

Question 18 Explanation:

Frequent findings in alcoholic cirrhosis include jaundice, palmar erythema, spider angiomas, parotid and lacrimal gland enlargement, clubbing of fingers, splenomegaly, muscle wasting, and ascites with or without peripheral edema. Increased peripheral formation of estrogen due to diminished hepatic clearance of the precursor androstenedione leads to gynecomastia, testicular atrophy and decreased body hair in men. In women, signs of virilization or menstrual irregularities may occur. Dupuytren’s contractures resulting from fibrosis of the palmar fascia with resulting flexion contracture of digits are associated with alcoholism but are not specifically related to cirrhosis.

Question 19

Zieve’s syndrome in alcoholics is best related to ?

A	Diarrhoea
B	Myocardial infarction
C	Hemolytic anemia
D	Pneumonia

Question 19 Explanation:

ZS is an acute metabolic condition that can occur during withdrawal from prolonged alcohol abuse. It consists of hemolytic anemia (spur cells and acanthocytes), hyperlipoproteinaemia, jaundice, and abdominal pain. The underlying cause is liver delipidization

Question 20

Which of the following presentation result from both hepatocellular insufficiency and portal hypertension ?

A	Ascites
B	Jaundice
C	Coagulopathy
D	Splenomegaly

Question 21

Which of the following presentation result from both hepatocellular insufficiency and portal hypertension ?

A	Splenomegaly
B	Jaundice
C	Coagulopathy
D	Hepatic encephalopathy

Question 21 Explanation:

Jaundice, edema, coagulopathy, and certain metabolic abnormalities are due to loss of functioning hepatocellular mass. Gastroesophageal varices and splenomegaly are due to portal hypertension. Ascites & hepatic encephalopathy result from both hepatocellular insufficiency & portal hypertension

Question 22

Alcoholic cirrhosis is also called ?

A	Gaucher’s cirrhosis
B	Johnson’s cirrhosis
C	Gilbert’s cirrhosis
D	Laennec’s cirrhosis

Question 22 Explanation:

Alcoholic cirrhosis, historically referred to as Laennec’s cirrhosis is the most common type of cirrhosis encountered in North America, western Europe and South America.

Question 23

Loss of liver cells in alcoholic cirrhosis is ?

A	Uniform
B	Patchy
C	Lobe specific
D	All of the above

Question 23 Explanation:

Alcoholic cirrhosis is characterized by diffuse fine scarring, fairly “uniform” loss of liver cells, and small regenerative nodules, and is called micronodular cirrhosis.

Question 24

Micronodular cirrhosis result from ?

A	Gall bladder stones
B	Following jejunoileal bypass
C	Following gastrectomy
D	Chronic pancreatitis

Question 25

In cirrhosis liver, cell loss generally ?

A	Lags replacement
B	Exceeds replacement
C	Equals replacement
D	Any of the above

Question 25 Explanation:

With continued alcohol intake and destruction of hepatocytes, fibroblasts, activated hepatic stellate cells and myofibroblasts appear at the site of injury and deposit collagen forming septa in periportal and pericentral zones surrounding remaining liver cells, which regenerate and form nodules. The cell loss generally exceeds replacement

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See all quizzes of Cirrhosis at here:

1.Reversal of fibrosis in cirrhosis liver can be achieved with
treatment in which of the following diseases ?
A. Chronic hepatitis C
B. Hemochromatosis
C. Alcoholic liver disease
D. All of the above

2.The cardinal pathologic features of cirrhosis liver are ?
A. Irreversible chronic injury of hepatic parenchyma
B. Extensive fibrosis
C. Formation of regenerative nodules
D. All of the above

3.The pathologic features of cirrhosis liver result from ?
A. Hepatocyte necrosis
B. Destruction of the supporting reticulin network
C. Distortion of the vascular bed
D. All of the above

4. Central event leading to hepatic fibrosis in cirrhosis liver is ?
A. Activation of the hepatic stellate cell
B. Activation of the CD 8+ cells
C. Activation of Kupffer cells
D. All of the above

5. In cirrhosis liver, activated hepatic stellate cells transform
into ?
A. Elastic tissue
B. Lymphoid tissue
C. Myofibroblasts
D. Hepatocytes
6. In cirrhosis liver, the stellate cell produces ?
A. Fibril-forming type I collagen
B. Fibril-forming type II collagen
C. Fibril-forming type III collagen
D. Fibril-forming type IV collagen
7. In cirrhosis liver, which of the following leads hepatic stellate
cells to produce collagen ?
A. TNF 
B. Insulin
C. Transforming growth factor  (TGF-)
D. Erythropoietin

8. Alcohol induced liver injury refers to ?
A. Cirrhosis liver
B. Alcoholic fatty liver
C. Alcoholic hepatitis
D. All of the above

9. Hepatic fibrosis secondary to chronic alcohol use is ?
A. Centrilobular
B. Pericellular
C. Periportal
D. Any of the above

10.The diameter of nodules in alcoholic cirrhosis is ?
A. < 0.5 mm
B. < 1 mm
C. < 2 mm
D. < 3 mm

11. Ethanol is mainly absorbed by ?
A. Stomach
B. Small intestine
C. Large intestine
D. All of the above

12. Which of the following initiates alcohol metabolism ?
A. Cytosolic alcohol dehydrogenase (ADH)
B. Microsomal-oxidizing system (MEOS)
C. Peroxisomal catalase
D. Gastric alcohol dehydrogenase (ADH)

13. Enzyme system for metabolism of alcohol in the liver is ?
A. Cytosolic alcohol dehydrogenase (ADH)
B. Microsomal ethanol oxidizing system (MEOS)
C. Peroxisomal catalase
D. All of the above

14.Ethanol is oxidized to acetaldehyde by ?
A. Cytosolic alcohol dehydrogenase (ADH)
B. Microsomal-oxidizing system (MEOS)
C. Peroxisomal catalase
D. Gastric alcohol dehydrogenase (ADH)

15. Which out of the following is a highly reactive molecule ?
A. Alcohol
B. Acetaldehyde
C. Acetate
D. All of the above

16. In alcoholic cirrhosis, clinical findings include ?
A. Palmar erythema
B. Spider angiomas
C. Lacrimal gland enlargement
D. All of the above
17. In alcoholic cirrhosis, clinical findings include all except ?
A. Clubbing of fingers

B. Muscle wasting
C. Signs of virilization in women
D. Xanthoma
18. Which of the following findings are associated with alcoholism
but are not specifically related to cirrhosis ?
A. Palmar erythema
B. Spider angiomas
C. Gynecomastia
D. Dupuytren’s contractures

19. Zieve’s syndrome in alcoholics is best related to ?
A. Diarrhoea
B. Myocardial infarction
C. Hemolytic anemia
D. Pneumonia

20.Which of the following presentation result from both
hepatocellular insufficiency and portal hypertension ?
A. Ascites
B. Jaundice
C. Coagulopathy
D. Splenomegaly
21. Which of the following presentation result from both
hepatocellular insufficiency and portal hypertension ?
A. Splenomegaly
B. Jaundice
C. Coagulopathy
D. Hepatic encephalopathy

22. Alcoholic cirrhosis is also called ?
A. Gaucher’s cirrhosis
B. Johnson’s cirrhosis
C. Gilbert’s cirrhosis
D. Laennec’s cirrhosis

23. Loss of liver cells in alcoholic cirrhosis is ?
A. Uniform
B. Patchy
C. Lobe specific
D. All of the above

24.Micronodular cirrhosis result from ?
A. Gall bladder stones
B. Following jejunoileal bypass
C. Following gastrectomy
D. Chronic pancreatitis

25. In cirrhosis liver, cell loss generally ?
A. Lags replacement
B. Exceeds replacement
C. Equals replacement
D. Any of the above

Cirrhosis

[MCQ] Cirrhosis- Part 1

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

Cirrhosis- Part 1

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