GIT Block Exam Flashcards by Aserah Blank

The highest concentration of this enzyme is seen in the central veins of the liver.

All of the above
Aldolase
Lactate Dehydrogenase
Phosphohexose isomerase
Isocitrate Dehydrogenase

Isocitrate Dehydrogenase

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NEGATIVE result for HBsAg may occur in the following:

vaccination
core window period
All of the above
no infection

ALL

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Cholestasis is characterized by the following:

Elevated alanine transaminase (ALT)
Elevated alkaline phosphatase (ALP)
All of the above
Hyperbilirubinemia with bilirubinuria
High serum bile salts
Hypercholesterolemia

ALL

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De Ritis ratio of > 1.0 but <2.0 may be seen in the following:

All of the above
alcoholic liver disease
myocardial infarction
cirrhosis & non viral hepatitis
acute viral hepatitis

acute viral hepatitis

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The following enzyme helps distinguish between elevated liver and bone isoenzymes of alkaline phosphatase.

Glucose-6-Phosphate Dehydrogenase
Cholinesterase
5-nucleotidase
All of the above
Aldolase

5-nucleotidase

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A 19 y.o. female was referred to your clinic by the police station, either for the confirmation or denial of an alleged rape. Microscopically, the vaginal discharge was negative for sperm cells. Which of the following could assist in your diagnosis?

Acid phosphatase
Leucine aminopeptidase
Gamma-glutamyl transpeptidase
All of the above
Alkaline phosphatase

Acid phosphatase

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Infection with this virus increases risk for the development of hepatocellular carcinomas:

HBV & HCV

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Which of the following is involved in protecting red cells from undergoing hemolysis on exposure to oxidants?

NADPH, Glutathione, G6PD
G6PD
Glutathione
None of the above

NADPH, Glutathione, G6PD

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Trace the fate of heme degradation after the release of hemoglobin from a senescent Red cell.

1) conjugation of bilirubin
2) conversion into stercobilin & urobilin
3) production of urobilinogen
4) heme iron is stored with ferritin
5) production of free bilirubin
6) remnants of heme converted to Biliverdin.

4-6-2-5-1-3
4-6-5-1-3-2
3-4-6-2-5-1
1-3-2-4-6-5
1-2-3-4-5-6

4-6-5-1-3-2

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The synthetic function of the liver can be monitored by measuring the levels of the following EXCEPT:

Platelet Count
All of the above
Albumin
Activated partial thromboplastin time (APTT)
Prothrombin time (PT)

Platelet Count

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Normal Values: gamma-glutamyl transpeptidase in female

0 - 45 U/L

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Normal Values: acid phosphatase

0 to 0.8 U/L

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Normal Values: G6PD

UI/RBC=220 – 550

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Normal Values: ALT

6-37 U/L

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Normal Values: cholinesterase

4.7-11.8 U/L

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Characteristic Gross Features of Condition: Focal Nodular Hyperplasia

none of the above
Infarct of Zahn
granuloma with caseating necrosis
”Nutmeg Liver”
hyperplastic area with central, stellate fibrous scar

hyperplastic area with central, stellate fibrous scar

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Characteristic Gross Features of Condition: passive congestion of the liver

”Nutmeg Liver”

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Portal Hypertension Effects on Lungs: Portopulmonary Hypertension

dyspnea on exertion with clubbing of fingers

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Characteristic Gross Features of Condition: Intrahepatic thrombosis of portal vein radicle

Infarct of Zahn

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Portal Hypertension Effects on Lungs: Hepatopulmonary Syndrome

Platypnea & orthodeoxia

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Describe the characteristic liver disease induced by these toxins: Isoniazid

Steatosis
Reye syndrome
induces an autoimmune-like hepatitis
mimics chronic viral hepatitis
None of the above

mimics chronic viral hepatitis

Describe the characteristic liver disease induced by these toxins: minocyclin

None of the above
Steatosis
Reye syndrome
mimics chronic viral hepatitis
induces an autoimmune-like hepatitis

induces an autoimmune-like hepatitis

Describe the characteristic liver disease induced by these toxins: aspirin

Reye syndrome

State how the following Alcohols are metabolized by the liver alcohol dehydrogenase: Isopropyl alcohol

acetone

State how the following Alcohols are metabolized by the liver alcohol dehydrogenase: Ethylene glycol

gycol-aldehyde, glycolic acid, glyoxylic acid

State how the following Alcohols are metabolized by the liver alcohol dehydrogenase: Methanol

formaldehyde and formic acid

Give the Pathogenesis of the Electrolyte Depletion in Alcoholism: hyponatremia * increased cellular uptake * none of the above * phosphorus deficiency * leaky membranes; from extracellular to intracellular * massive intake of solute-free fluid

massive intake of solute-free fluid

Give the Pathogenesis of the Electrolyte Depletion in Alcoholism: hypokalemia

leaky membranes; from extracellular to intracellular

Give the Pathogenesis of the Electrolyte Depletion in Alcoholism: hypomagnesemia

phosphorus deficiency

Distinguish the different cholestatic liver diseases as to their Morphology: Primary Sclerosing Cholangitis

chronic inflammation of largest ducts; onion skinning of smaller ducts

Distinguish the different cholestatic liver diseases as to their Morphology: Neonatal Cholestasis

extrahepatic biliary atresia with idiopathic Hepatitis

Distinguish the different cholestatic liver diseases as to their Morphology: Cholestasis of Sepsis

prominent Kupffer cells; canals of Hering with prominent bile plugs

Classify the CIRCULATORY DISORDERS of the Liver according to their causes: Cirrhosis * Hepatic Vein Outflow Obstruction * All of the above * Impaired Blood Flow into the Liver * Impaired Blood Flow Through the Liver

Impaired Blood Flow Through the Liver

Classify the CIRCULATORY DISORDERS of the Liver according to their causes: Hepatic Vein Thrombosis (Budd-Chiari Syndrome)

Hepatic Vein Outflow Obstruction

Classify the CIRCULATORY DISORDERS of the Liver according to their causes: Subclinical thrombosis of the portal vein (Banti syndrome)

Impaired Blood Flow into the Liver

Classify the CIRCULATORY DISORDERS of the Liver according to their causes: sickle cell disease

Impaired Blood Flow Through the Liver

Describe the Biliary Tumors according to their Clinical Manifestation: cause symptoms only when much of the liver is replaced by tumor.

Intrahepatic biliary tumors

Describe the Biliary Tumors according to their Clinical Manifestation: jaundice, acholic stools, nausea and vomiting, and weight loss.

• Extrahepatic biliary tumor

Describe the morphologic appearance of the different stages of Cholecystitis: Acute Cholecystitis

gallbladder enlarged, tense, bright red or blotchy, covered by fibrinous exudate.

Describe the morphologic appearance of the different stages of Cholecystitis: Chronic Cholecystitis

contracted or enlarged; thickened from fibrosis

Describe the morphologic appearance of the different stages of Cholecystitis: Gangrenous Cholecystitis

edematous, and hyperemic to green-black necrotic organ

This is a characteristic of Chronic Hepatitis: * widespread scarring * muddy-red, mushy appearance * wrinkled, baggy capsule * slightly mottled * None of the above

widespread scarring

Salient features of Autoimmune Hepatitis EXCEPT: * Female predominance (70%) * presence of other autoimmune diseases * No serologic evidence of viral infection * Elevated serum IgM * All of the above

Elevated serum IgM

Excessive iron is directly toxic to tissues by the following mechanisms EXCEPT: None of the above • Acts as xenobiotics and triggers for the immune response • all the above • Stimulation of collagen formation • Direct irreversible oxidative damage of iron to DNA • Lipid peroxidation by iron-catalyzed free radical reactions

Acts as xenobiotics and triggers for the immune response

Copper cause toxic injury to different organs by these mechanisms EXCEPT: * binding to sulfhydryl groups of cellular proteins, * displacing other metals in hepatic metalloenzymes. * promoting the formation of free radicals, * apoceruloplasmin conversion to ceruloplasmin is inhibited * All of the above

apoceruloplasmin conversion to ceruloplasmin is inhibited

Differentiate pre-hepatic & post-hepatic jaundice: Pre-hepatic Jaundice (Elevated serum Bilirubin) * Indirect & Total Bilirubin * Direct Bilirubin only * All Bilirubins * Indirect Bilirubin only * none of the above * Direct & Total Bilirubin

Indirect Bilirubin only

Differentiate pre-hepatic & post-hepatic jaundice: Post-hepatic Jaundice (Elevated serum Bilirubin)

Direct Bilirubin only

Differentiate pre-hepatic & post-hepatic jaundice: Urine Bilirubin (Pre-hepatic Jaundice)

negative

Differentiate pre-hepatic & post-hepatic jaundice: Stool (Pre-hepatic Jaundice)

darkly colored

Differentiate pre-hepatic & post-hepatic jaundice: Risk of Kernicterus: (Pre-hepatic Jaundice)

increased risk