End of block formative Flashcards
Acute pancreatitis is associated with
Select one:
a. diuretics
b. opiate use
c. steroid use
d. 3rd generation cefalosporins
e. 2nd generation cefalosporins
Steroid use
Which of the following biochemical findings is commonly seen in patients with established alcoholic liver disease (ALD) (cirrhosis)?
Select one:
a. Hypernatraemia due to secondary hyperaldosteronism
b. Hyperbilirubinaemia, resulting in clinical jaundice.
c. Grossly elevated triglycerides, due to release of very low density lipoproteins from cirrhotic liver.
d. Increased urea due to small GI bleeds from oesophageal varices.
e. Markedly increased ALT reflecting liver damage due to alcohol ‘binges’.
Hyperbilirubinaemia, resulting in clinical jaundice.
Alcohol is know to
Select one:
a. increase blood triglyceride levels
b. decrease blood LDL levels
c. increase blood HDL levels
d. decrease blood HDL levels
e. increase blood LDL levels
Increase blood HDL levels
Which of the following nutritional deficiencies often found following chronic alcohol abuse, is associated with Wernicke–Korsakoff syndrome?
Select one:
a. zinc
b. thiamine
c. vitamin A
d. iron
e. vitamin B3
Thiamine
In general, females become intoxicated more rapidly than males because
Select one:
a. they are less accustomed to drinking
b. they tend to have less alcohol dehydrogenase
c. they consume different types of alcohol
d. they tend to have a higher BMI
e. they tend to have smaller livers
They tend to have less alcohol dehydrogenase
Which of the drugs below leads to a faster rate of alcohol absorption?
Select one:
a. domperidone
b. aluminium hydroxide
c. magnesium carbonate
d. omeprazole
e. penicillin
Domperidone
According to the World Cancer Research Fund, for which of the following cancers is there strong evidence of an association with alcohol consumption?
Select one:
a. prostate
b. ovarian
c. breast
d. lung
e. bladder
Breast
Which of the following statements about the osmolal gap is true?
Select one:
a. A raised osmolal gap is associated with a raised urine output
b. Toxic alcohol ingestion should only be considered if there is a reported history of ingestion of e.g. anti-freeze.
c. Most patients presenting with a reduced level of consciousness have an increased osmolal gap due to alcohol (ethanol).
d. Ethanol is sometimes used to treat patients with a raised osmolal gap.
e. Occasionally, the measured serum osmolality is significantly lower than the calculated osmolality.
Ethanol is sometimes used to treat patients with a raised osmolol gap
Portal hypertension is most associated with
Select one:
a. splenomegaly
b. hepatomegaly
c. positive Murphy’s sign
d. positive Courvoisier’s sign
e. Cullen’s sign
Splenomegely
In the process of death certification conditions listed under part 2 refer to
Select one:
a. co-existent chronic diseases
b. past medical history
c. conditions contributing to but not directly repsonsible for death
d. inherited diseases
e. conditions that are a public health risk
Conditions contributing but not directly responsible for death
The usual time scale for the development of Delerium Tremens is
Select one:
a. 3-10 hours
b. 2-3 days
c. 4-12 hours
d. 3-10 days
e. 6 - 48 hours
3-10 days
Which clotting factor is NOT made in the liver?
Select one:
a. X
b. VII
c. IX
d. II
e. VIII
VIII
Which of these medications is used for Medically Assisted Alcohol Withdrawal
Select one:
a. lorazepam
b. chlordiazepoxide
c. disulfiram
d. haloperidol
e. acramposate
Chlordiazepoxide
Antabuse - a drug used to treat alcoholism work by inhibiting
Select one:
a. alkaline phosphatase
b. alcohol phosphatase
c. aldehyde phosphatase
d. aldehyde dehydrogenase
e. alcohol dehydrogenase
Aldehyde dehydrogenase
Microscopically, hepatocytes are bordered by
Select one:
a. Virchow-Robin space
b. venules
c. Bowman’s space
d. arterioles
e. the space of Disse
the space of disse
Aspiration pneumonia typically occurs in the
Select one:
a. superior segment of the right lower lobe
b. lower segment of the left lower lobe
c. proximal segment of the right median lobe
d. lower segment of the right lower lobe
e. upper post segment of the left lower lobe
Superior segment of the right lower lobe
The ligamentum teres within the falciform ligament is formed from which embryological structure?
Select one:
a. umbilical artery
b. vitelline duct
c. umbilical vein
d. mesonephric duct
e. urachus
Umbillical vein
Fibrosis.cirrhosis of the liver is mediated by which type of cell?
Select one:
a. macrophages
b. hepatocytes
c. lymphocytes
d. neutrophils
e. interstitial cells of Ito
Interstitial cells of lto
How many units of alcohol are in a 1 litre bottle of premium strength cider (8%)?
Select one:
a. 6
b. 12
c. 4
d. 8
e. 10
8
According to the UK Chief Medical Officer, what is a safe limit on alcohol intake during pregnancy?
Select one:
a. 1-2 units a day
b. 2-3 units a day
c. 1-2 units a week
d. 2-3 units a week
e. none - there is no safe limit
None
The abnormal gait seen in Wernicke’s syndrome is known as an
Select one:
a. a vaulting gait
b. ataxic gait
c. an antalgic gait
d. a spastic gait
e. a shuffling gait
Ataxic gait
Alcohol causes a diuresis because of
Select one:
a. increased ADH levels
b. decreased aldosterone levels
c. decreased ADH levels
d. increased sodium levels
e. increased aldosterone levels
Decreased ADH levels
In the normal metabolic pathway the substance from which bilirubin is formed is
Select one:
a. urobilinogen
b. haptoglobin
c. porhyrin
d. biliverdin
e. haemaglobin
Bilverdin
What is the definition of binge drinking for a man?
Select one:
a. greater than eight units in one day
b. greater than 6 units in one day
c. greater than 12 units in one day
d. greater than 4 units in one day
e. greater than 10 units in one day
Greater than 8 units in one day
Severe hepatitis is associated with
Select one:
a. hepatorenal syndrome
b. hepatoreticular syndrome
c. hepatocardiac syndrome
d. hepatobiliary syndrome
e. hepatorespiratory syndrome
Hepatorenal syndrome
Which of the following statements about upper gastro-intestinal (GI) bleeding is true?
Select one:
a. ADH (antidiuretic hormone) is stimulated primarily by the increased serum osmolality resulting from the increased urea.
b. Urine biochemistry is of little help in assessing the impact of blood loss on glomerular function
c. In a patient with a severe GI bleed, lactate may be used to assess perfusion.
d. Red blood cells from the gut enter the systemic circulation directly
In a patient with a severe GI bleed, lactate may be used to assess perfusion
Which of the following is a useful screening tool for Alcohol Dependence Disorder
Select one:
a. MoCA
b. DAST
c. AUDIT
d. PHQ-9
e. COWS
AUDIT
The liver enzyme AST is short for
Select one:
a. Aspartate transaminase
b. Aspartate aminotransferase
c. Alanine synthase
d. Alanine S-transferase
e. Aspartate Transferase
Aspartate aminotransferase
Which of these microscopic features is NOT present within a portal tract?
Select one:
a. lymphocyte
b. bile duct
c. vein
d. hepatocyte
e. artery
Hepatocyte
In a patient with alcoholic liver disease (ALD) presenting with an upper GI bleed, which of the following provides the most useful information about liver synthetic function?
Select one:
a. serum albumin
b. serum urea
c. prothrombin time
d. Triglycerides
e. total protein
Prothrombin time
How many kcals does 1g of alcohol contain?
Select one:
a. 7
b. 6
c. 4
d. 10
e. 9
7
A patient with LFTs showing a normal GGT, AST and ALT with high Alk Phos is most likely to have
Select one:
a. recently drunk significant amounts of alcohol (binge drinking)
b. viral hepatitis
c. bone disease
d. pulmonary disease
e. chronic alcoholism
Bone disease
Dupuytren’s contracture is caused by
Select one:
a. scarring of flexor policis longus
b. scarring of the palmar fascia
c. scarring of the flexor tendons
d. scarring and swelling of the tendon sheath
e. scarring of flexor policis brevis
Scarring of the palmar fascia
Jaundice as a result of alcoholic hepatitis is caused by an accumulation of
Select one:
a. conjugated biliverdin
b. haptoglobin
c. unconjugated biliverdin
d. unconjugated bilirubin
e. conjugated bilirubin
Conjugated bilirubin
Facial flushing and a general feeling of being unwell is caused by
Select one:
a. acetic acid
b. alcohol
c. alcohol dehydrogenase
d. aldehyde
e. aldehyde dehydrogenase
Aldehyde
What is the definition of “binge drinking” for a woman?
Select one:
a. greater than 10 units in one day
b. greater than 4 units in one day
c. greater than 12 units in one day
d. greater than 8 units in one day
e. greater than 6 units in one day
Greater than 8 units in one day
Which of these speeds up the elimination of alcohol form the body
Select one:
a. caffeine consumption
b. all of the above
c. glucose solution
d. none of the above
e. water consumption
None of the above
Which of the following is NOT associated with acute pancreatitis?
Select one:
a. Grey Turner’s sign
b. resp failure
c. Cullen’s sign
d. Caput Medusae
e. renal failure
Renal failure
How many units of alcohol are in a 70cl bottle of 40% vodka?
Select one:
a. 14
b. 20
c. 40
d. 28
e. 57
28
Which of these is NOT a recognised feature of Dependence Syndrome as per ICD – 10
Select one:
a. Preoccupation with substance use
b. narrowing of repertoire
c. increased tolerance
d. Persistent use despite clear evidence of harm
e. Strong desire or compulsion to take substance
Narrowing of repertoire
