In a Liver Function Test, the Cholestatic Enzymes That Are Reported Include

In a liver function test, the cholestatic enzymes that are reported include

a) alanine transaminase.

b) aspartate transaminase.

c) lactate dehydrogenase.

d) pseudocholinesterase.

e) gamma-glutamyl transpeptidase.

A patient is most likely to be infected with which type of hepatitis virus if all of the following

conditions apply:

i. the source is blood or blood-derived body fluids;

ii. the route of transmission is percutaneous or permucosal;

iii. the infection is chronic;

iv. the recommended protection is donor screening and behaviour modification.

a) Hepatitis A

b) Hepatitis B

c) Hepatitis C

d) Hepatitis D

e) Hepatitis E

The risk of long-term harm from the ingestion of six (6) standard drinks of alcohol per average day, with 40 standard drinks in the week, is considered ______for the average adult female.

a) negligible

b) low risk

c) risky

d) high risk

e) extreme risk

Without functioning hepatocytes, protein catabolism is a toxic process due to

a) production of ammonia.

b) excessive HCl production.

c) build up of the parts of amino acids remaining after deamination.

d) clogging of bile canaliculi with denatured proteins.

e) increased fluid volume.

Excess cholesterol is transported to the liver for elimination by

a) high density lipoproteins.

b) low density lipoproteins.

c) very low density lipoproteins.

d) chylomicrons.

e) ketone bodies.

Portosystemic shunting in liver cirrhosis takes place in all the following sites except

a)  Liver

b)  Rectum

c)  Oesophagus

d)  Stomach

e)  Colon

If a 3 year old child was infected with Hepatitis B at birth, what is the chance the condition is chronic and what serological markers would be still present?

a)  70 – 80% Anti-HBc (IgM) and anti-HBs

b)  80 – 90% Anti-HBc (IgM) and HBeAg

c)  50 – 60% HBsAg

d)  80 – 90% Anti-HBc (Total) and HBsAg

If a blood test taken from a suspected hepatitis case comes back as -ve for HCV RNA but +ve for Anti-HCV it could mean

a)  Acute or chronic HCV infection depending on clinical context

b)  Absence of HCV infection

c)  Resolution of HCV, OR Acute HCV during period of low-level viremia

d)  Early acute HCV infection OR chronic HCV in immunocompromised patient

True or False

Hepatitis C is regularly transmitted via normal heterosexual contact

Features of simple alcohol withdrawal do not include

a) tremor.

b) nausea.

c) disorientation.

d) anxiety.

e) insomnia.

Alcohol’s insult on the liver follows the continuum given

a)  Normal liver à Steatosis àHepatitis à Cirrhosis

b)  Normal liver à Steatosis/ Hepatitis à Cirrhosis

c)  Normal liver à Hepatitis à Alcoholic liver disease à Cirrhosis

d)  Normal liver à Cirrhosis à Hepatocellular Carcinoma

Blood tests that show hepatocyte function include:

a)  AST, ALT, Serum albumin and serum ammonia

b)  Prothrombin time and Serum albumin

c)  Total Bilirubin, AST, ALT

d)  AST, ALT, GGT, alkaline phosphatase

Remembering that ALT is more specific liver marker than AST, what pathology could be present if you were clinically suspicious of a hepatic cause of an ALT = 50 but AST = 150?

a)  Alcoholic liver disease

b)  Viral Hepatitis

c)  Acute fatty liver of pregnancy

d)  Cholestasis

What is the best measure of acute hepatic function?

a)  GGT

b)  Serum albumin

c)  Serum ammonia

d)  Prothrombin time

With regard to imaging of the liver:

a)  Ultrasound is primarily used to stage tumours

b)  CT can identify steatosis

c)  CT and MRI are used to stage tumours

d)  Ultrasound is not good at identifying dilated biliary trees

Wilson’s disease can lead to:

a)  Cirrhosis and chronic hepatitis

b)  Hepatic flap

c)  Mallory’s hyaline

d)  Dupuytren’s contracture

Outline 3 ways by which cirrhosis leads to portal Hypertension….