Geri 2

Question 1

NASH biopsy contains:

Answer 1

Steatosis
Ballooning
Lobular inflammation
Fibrosis

Question 2

Susan has metabolic syndrome. Her fasting sugars have been between 100 and 110. Her recent abdominal ultrasound suggests an echogenic liver. You decide to evaluate her for insulin resistance. You order a fasting glucose and fasting insulin level. Using the HOMA-IR formula, what is the lowest calculated value that has prognostic significance concerning development of fatty liver disease?

Answer 2

> 3

Question 3

The condition known as Non-alcoholic Fatty Liver Disease (NAFLD) is largely a manifestation of:

Answer 3

obesity and metabolic syndrome

Question 4

Test to confirm diagnosis of NASH:

Answer 4

Liver biopsy

Question 5

Mechanism linking NAFLD with coronary artery atherosclerosis:

Answer 5

Endothelial dysfunction

Question 6

Pt with chronic Hep C, normal LFT’s. How will we screen for hepatobiliary cancer.

Answer 6

alpha-fetoprotein and abdominal ultrasound every 6 months

Question 7

60 y/o male, abnormal LFT x 6 months, 2 cm liver mass on ultrasound, pt afraid of needles and surgery. How will you determine if this is hepatocellular carcinoma?

Answer 7

helical CT and alpha-fetoprotein

Question 8

Benign process in the NAFLD spectrum

Answer 8

Simple steatosis

Question 9

Which ethnic group has the lowest incidence of Fatty Liver Disease?

Answer 9

African Americans

Question 10

65 y/o female, abdominal pain, bloating, anorexia, 15# weight loss over 8 weeks, jaundice, elevated Ca 19-9. What does this confirm?

Answer 10

Nuffin’

Question 11

Weight loss, prominent rib cage, thin arms and legs:

Answer 11

Cachexia

Question 12

3 most common causes of involuntary weight loss in elderly:

Answer 12

Cancer
Depression
GI problems

Question 13

79 y/o f, alzheimers, weight loss. What should you prescribe to help out?

Answer 13

Multivitamin

Question 14

Schizophrenic has lost 12 pounds in 2 months, reports seeing men in black suits poisoning the food. Best treatment:

Answer 14

First, make sure there aren’t actually men in black poisoning his food!

Also, evaluate and treat his psychosis

Question 15

Fat around belly, scrawny arms and legs:

Answer 15

Sarcopenic obesity

Question 16

71 y/o m, 39 year hx crohn’s, recent N/V, 20# wt loss over 2 months, low protein and albumin, no obstruction or stricture on imaging, elevated fecal alpha-1 antitrypsin. Likely diagnosis:

Answer 16

protein-losing enteropathy

Question 17

hypothyroid, hyperlipid, a-fibby, diabeetus 2 (the pancreas strikes back), now has high urine microalbumin. Why?

Answer 17

Kidney got jacked by the diabeetus

Question 18

76 y/o Nazi leader, 6 mo post whipple, 30# weight loss in 6 months, eating well with normal poops. Prealbumin is helpful because:

Answer 18

prealbumin is a more sensitive indicator of protein synthesis and catabolism

Question 19

U-dip shows glycosuria, what is the serum glucose?

Answer 19

> 180 mg/dL

Question 20

Depressed elderly widower, 8# weight loss over 4 months, says meals on wheels is salty and gross. Plan?

Answer 20

mirtazapine