[MCQ] Cirrhosis- Part 6

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

Cirrhosis- Part 6

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 Cirrhosis- Part 6. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

“Caput medusae” is best related to ?

A	Cardioesophageal junction
B	Rectum
C	Retroperitoneal space
D	Falciform ligament of liver

Question 1 Explanation:

Major sites of portalsystemic collateral flow are veins around cardioesophageal junction (esophagogastric varices), rectum (hemorrhoids), retroperitoneal space & falciform ligament of liver (periumbilical or abdominal wall collaterals). Abdominal wall collaterals appear as tortuous epigastric vessels that radiate from umbilicus toward xiphoid & rib margins (caput medusae).

Question 2

Upper gastrointestinal tract is upto ?

A	Pylorus
B	Ampulla of Vater
C	Ligament of Treitz
D	End of jejunum

Question 2 Explanation:

Upper GI is above the ligament of Treitz. Over 90% of patients with melena are bleeding proximal to the ligament of Treitz, and about 90% of patients with hematochezia are bleeding from the colon.

Question 3

Most common cause of upper GI bleeding (UGIB) is ?

A	Esophageal varices
B	Peptic ulcers
C	Gastroduodenal erosions
D	Erosive esophagitis

Question 3 Explanation:

Peptic ulcers are the most common cause of UGIB, accounting for up to ~50% of cases.

Question 4

For melena, blood should be present in GI tract for what duration ?

A	3 hours
B	7 hours
C	14 hours
D	22 hours

Question 4 Explanation:

Melena indicates that blood has been present in the GI tract for at least 14 hours.

Question 5

Clues to upper gastrointestinal bleed include ?

A	Hyperactive bowel sounds
B	Melena
C	Elevated blood urea nitrogen
D	All of the above

Question 6

Gastric antral vascular ectasia is the cause of ?

A	Washermen stomach
B	Watermelon stomach
C	Windmill stomach
D	Windshield stomach

Question 7

Which of the following should be the first-line treatment to control bleeding acutely ?

A	Somatostatin / octreotide
B	Balloon tamponade
C	Emergency portal-systemic nonselective shunts
D	Endoscopic intervention

Question 8

Sengstaken-Blakemore tube has how many lumens ?

A	1
B	2
C	3
D	4

Question 9

Minnesota tube has how many lumens ?

A	1
B	2
C	3
D	4

Question 10

“TIPS” stands for ?

A	Transcuteneous intrahepatic portosystemic shunt
B	Transvenous intrahepatic portosystemic shunt
C	Transjugular intrahepatic portosystemic shunt
D	Transarterial intrahepatic portosystemic shunt

Question 10 Explanation:

Decompression procedure to lower portal pressure is accomplished without surgery through percutaneous placement of a portal-systemic shunt, termed transjugular intrahepatic portosystemic shunt (TIPS).

Question 11

Hepatic encephalopathy occurs in what proportion of patients after TIPS ?

A	10 %
B	20 %
C	30 %
D	40 %

Question 11 Explanation:

Hepatic encephalopathy occur in 20 % of patients after TIPS.

Question 12

Intravenous infusion of vasopressin results in ?

A	Generalized vasoconstriction
B	Vasoconstriction in portal venous system only
C	Vasoconstriction in systemic venous system only
D	None of the above

Question 12 Explanation:

Intravenous infusion of vasopressin at a rate of 0.1 to 0.4 U/min results in “generalized vasoconstriction” leading to diminished blood flow in the portal venous system.

Question 13

Somatostatin and octreotide are ?

A	Generalized vasoconstrictors
B	Direct splanchnic vasoconstrictors
C	Direct systemic vasoconstrictors
D	None of the above

Question 13 Explanation:

Somatostatin and its analogue, octreotide, are direct splanchnic vasoconstrictors

Question 14

Serious side effects associated with vasopressin therapy are all except ?

A	Cardiac ischemia
B	Gastrointestinal tract ischemia
C	Acute renal failure
D	Hypernatremia

Question 14 Explanation:

Serious side effects associated with vasopressin therapy include cardiac and gastrointestinal tract ischemia, acute renal failure, and hyponatremia.

Question 15

Concurrent use of which drug may enhance the effectiveness of vasopressin and reduce complications ?

A	Somatostatin
B	Octreotide
C	Nitroglycerin / isosorbide dinitrate
D	All of the above

Question 15 Explanation:

Concurrent use of venodilators like IV nitroglycerin or isosorbide dinitrate sublingually may enhance the effectiveness of vasopressin and reduce complications.

Question 16

Which of the following agents is useful in the treatment of portal hypertensive gastropathy ?

A	Proton pump inhibitors
B	H2 receptor blockers
C	Sucralfate
D	None of the above

Question 16 Explanation:

Congestive gastropathy due to the venous hypertension is a complication of portal hypertension. Nonselective beta-adrenergic blockade is sometimes effective. Proton pump inhibitors or other agents useful in the treatment of peptic disease are usually not helpful.

Question 17

In absence of cirrhosis, splenomegaly with variceal hemorrhage suggests the possibility of ?

A	Splenic vein thrombosis
B	Portal vein thrombosis
C	Splenic hamorrhage
D	Any of the above

Question 17 Explanation:

In the absence of cirrhosis, splenomegaly in association with variceal hemorrhage should suggest the possibility of splenic vein thrombosis

Question 18

For isolated gastric varices due to splenic vein thrombosis, which of the following is curative ?

A	Beta adrenergic blockers
B	TIPS
C	Portal-systemic shunts
D	Splenectomy

Question 19

Theories proposed for ascites include ?

A	“Underfilling” theory
B	“Overflow” theory
C	“Peripheral arterial vasodilation” theory
D	All of the above

Question 20

Hepatic hydrothorax is more common on which side ?

A	Right side
B	Left side
C	Bilateral
D	Any of the above

Question 20 Explanation:

Hepatic hydrothorax is more common on right side due to a rent in the diaphragm with free flow of ascitic fluid into the thoracic cavity.

Question 21

What does SAAG stand for ?

A	Serum ascites-to-albumin gradient
B	Serum albumin-to-ascites gradient
C	Serum albumin-to-anion gradient
D	Serum anion-to-albumin gradient

Question 21 Explanation:

In cirrhosis, protein concentration of ascitic fluid is low (<1 g/dL). With the use of serum ascites-toalbumin gradient (SAAG), terms like exudative or transudative fluid have been replaced. Cirrhosis leading to portal hypertension leading to ascitis, gradient between serum albumin level and ascitic fluid albumin level is >1.1 g/dL. When the gradient is <1.1 g/dL, infectious or malignant causes of ascites should be considered.

Question 22

There is an increased risk for developing which of the following when levels of ascitic fluid proteins are very low ?

A	Refractory ascites
B	Hepatic Encephalopathy
C	Spontaneous Bacterial Peritonitis (SBP)
D	Hepatocellular cancer

Question 22 Explanation:

When levels of ascitic fluid proteins are very low, patients are at increased risk for developing SBP.

Question 23

What absolute level of polymorphonuclear leukocytes count suggests ascitic fluid infection ?

A	> 100 / μL
B	> 150 / μL
C	> 200 / μL
D	> 250 / μL

Question 23 Explanation:

A high level of red blood cells in the ascitic fluid signifies a traumatic tap or perhaps a hepatocellular cancer or a ruptured omental varix. When the absolute level of polymorphonuclear leukocytes is >250/μL, the question of ascitic fluid infection should be strongly considered.

Question 24

The recommended amount of sodium per day in the management of ascites is ?

A	< 2 gram
B	< 4 gram
C	< 6 gram
D	< 8 gram

Question 24 Explanation:

< 2 gram of sodium per day is the recommended amount in the management of ascites.

Question 25

Ascites may be demonstrated on physical examination when peritoneal fluid accumulation exceeds ?

A	200 ml
B	500 ml
C	1000 ml
D	1500 ml

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 Cirrhosis at here:

1“Caput medusae” is best related to ?
A. Cardioesophageal junction
B. Rectum

C. Retroperitoneal space
D. Falciform ligament of liver

2. Upper gastrointestinal tract is upto ?
A. Pylorus
B. Ampulla of Vater
C. Ligament of Treitz
D. End of jejunum

3. Most common cause of upper GI bleeding (UGIB) is ?
A. Esophageal varices
B. Peptic ulcers
C. Gastroduodenal erosions
D. Erosive esophagitis
4. For melena, blood should be present in GI tract for what
duration ?
A. 3 hours
B. 7 hours
C. 14 hours
D. 22 hours

5. Clues to upper gastrointestinal bleed include ?
A. Hyperactive bowel sounds
B. Melena
C. Elevated blood urea nitrogen
D. All of the above

6. Which of the following is false about Dieulafoy’s lesion ?
A. Large-caliber arteriole beneath gastrointestinal mucosa
B. Bleeds through a pinpoint mucosal erosion
C. Most common on greater curvature of proximal stomach
D. Also called persistent caliber artery
7. Gastric antral vascular ectasia is the cause of ?
A. Washermen stomach
B. Watermelon stomach
C. Windmill stomach
D. Windshield stomach

8. Which of the following should be the first-line treatment to
control bleeding acutely ?
A. Somatostatin / octreotide
B. Balloon tamponade
C. Emergency portal-systemic nonselective shunts
D. Endoscopic intervention

9. Sengstaken-Blakemore tube has how many lumens ?
A. 1
B. 2
C. 3
D. 4
10. Minnesota tube has how many lumens ?
A. 1
B. 2
C. 3
D. 4

11. “TIPS” stands for ?
A. Transcuteneous intrahepatic portosystemic shunt
B. Transvenous intrahepatic portosystemic shunt
C. Transjugular intrahepatic portosystemic shunt
D. Transarterial intrahepatic portosystemic shunt

12. Hepatic encephalopathy occurs in what proportion of patients
after TIPS ?
A. 10 %
B. 20 %
C. 30 %
D. 40 %
13. Intravenous infusion of vasopressin results in ?
A. Generalized vasoconstriction
B. Vasoconstriction in portal venous system only
C. Vasoconstriction in systemic venous system only
D. None of the above

14. Somatostatin and octreotide are ?
A. Generalized vasoconstrictors
B. Direct splanchnic vasoconstrictors
C. Direct systemic vasoconstrictors
D. None of the above

15. Serious side effects associated with vasopressin therapy are
all except ?
A. Cardiac ischemia
B. Gastrointestinal tract ischemia
C. Acute renal failure
D. Hypernatremia

16. Concurrent use of which drug may enhance the effectiveness
of vasopressin and reduce complications ?
A. Somatostatin
B. Octreotide
C. Nitroglycerin / isosorbide dinitrate
D. All of the above

17. Which of the following agents is useful in the treatment of portal
hypertensive gastropathy ?
A. Proton pump inhibitors
B. H2 receptor blockers
C. Sucralfate
D. None of the above

18. In absence of cirrhosis, splenomegaly with variceal hemorrhage
suggests the possibility of ?
A. Splenic vein thrombosis
B. Portal vein thrombosis
C. Splenic hamorrhage
D. Any of the above

19. For isolated gastric varices due to splenic vein thrombosis,
which of the following is curative ?
A. Beta adrenergic blockers
B. TIPS
C. Portal-systemic shunts
D. Splenectomy

20. Theories proposed for ascites include ?
A. “Underfilling” theory
B. “Overflow” theory
C. “Peripheral arterial vasodilation” theory
D. All of the above
21. Hepatic hydrothorax is more common on which side ?
A. Right side
B. Left side
C. Bilateral
D. Any of the above

22. What does SAAG stand for ?
A. Serum ascites-to-albumin gradient
B. Serum albumin-to-ascites gradient
C. Serum albumin-to-anion gradient
D. Serum anion-to-albumin gradient

23. There is an increased risk for developing which of the following
when levels of ascitic fluid proteins are very low ?
A. Refractory ascites
B. Hepatic Encephalopathy
C. Spontaneous Bacterial Peritonitis (SBP)
D. Hepatocellular cancer

24. What absolute level of polymorphonuclear leukocytes count
suggests ascitic fluid infection ?
A. > 100 / μL
B. > 150 / μL
C. > 200 / μL
D. > 250 / μL

25. The recommended amount of sodium per day in the
management of ascites is ?
A. < 2 gram
B. < 4 gram
C. < 6 gram

D. < 8 gram

26. Ascites may be demonstrated on physical examination when
peritoneal fluid accumulation exceeds ?
A. 200 ml
B. 500 ml
C. 1000 ml
D. 1500 ml

Cirrhosis

[MCQ] Cirrhosis- Part 6

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

Cirrhosis- Part 6

Share this:

Related

[MCQ] Cirrhosis- Part 5

[MCQ] Cirrhosis- Part 7

You may also like

Leave a Comment Cancel Reply