Liver Disease week 4

Question 1

Which is more common in the United States, chronic alcoholic liver disease or non-alcoholic fatty liver disease?
Select one:
a. chronic alcoholic liver disease
b. non-alcoholic fatty liver disease

Answer 1

b. non-alcoholic fatty liver disease NAFLD

Question 2

You are taking a patient history and ask a 45-year-old male how many alcoholic beverages he drinks per week. Which of the following is considered a safe level of alcohol consumption?
Select one:
a. 3 or 4 12-ounce cans of beer, 3x per week
b. 1 or 2 12-ounce cans of beer every day

Answer 2

b. 1 or 2 12-ounce cans of beer every day

Question 3

Of the given choices, which liver pathology is least likely to cause clinical symptoms?
Select one:
a. fibrosis
b. steatohepatitis
c. steatosis

Answer 3

c. steatosis

Question 4

Steatosis is caused by an accumulation of ________ in the hepatocytes.

Answer 4

Triglycerides

Question 5

NASH (non-alcoholic steatohepatitis) is potentially reversible.
Select one:
True
False

Answer 5

True

Question 6

Which type of ACUTE viral hepatitis infection is most common in the United States?
Select one:
a. A
b. B 
c. D
d. E

Answer 6

b. B

Question 7

Aside from the potential to lead to liver failure, what is the other major health concern associated with cirrhosis?

Answer 7

Hepatocellular carcinoma (HCC)

Question 8

Hepatitis A, B, and C viruses have the potential to cause chronic liver infection.
Select one:
True
False

Answer 8

False

Question 9

What is the preferred 1st line imaging study to evaluate the liver and gallbladder?
Select one:
a. ultrasound 
b. MRI
c. CT scan

Answer 9

a. ultrasound

Question 10

Checking labs to screen for viral hepatitis is useful in making the diagnosis of NAFLD (non-alcoholic fatty liver disease).
Select one:
True
False

Answer 10

True

It is important to rule out other potential causes of steatohepatitis before concluding that NAFLD is the correct diagnosis. Other conditions to rule out include:

• Alcohol abuse
• Chronic viral hepatitis - especially Hep C
• Autoimmune liver disease
• Iron or copper overload
• Medication side effects (example: chronic oral corticosteroid use)

Question 11

Which viral hepatitis strain is transmitted by fecal-oral route?
Select one:
a. C
b. A 
c. B

Answer 11

b. A

Question 12

Which viral hepatitis strain is most likely to become a chronic infection?
Select one:
a. A
b. B
c. C

Answer 12

c. C

Question 13

Which viral hepatitis strain does NOT have an available immunization to prevent infection from it?
Select one:
a. B
b. C 
c. A

Answer 13

b. C

Question 14

Which risk factor is more likely to be the cause of hepatitis B infection in the United States?
Select one:
a. not properly washing fresh fruits and veggies
b. sharing a drink with a patient with hepatitis B
c. sharing a contaminated needle during IV drug use
d. kissing someone with hepatitis B

Answer 14

c. sharing a contaminated needle during IV drug use

Question 15

Which diet is recommended for treatment of NAFLD in an overweight or obese patient?
Select one:
a. either A or B
b. low carb diet
c. low fat diet

Answer 15

a. either A or B

Weight loss is the treatment for NAFLD but there is no evidence to suggest that a particular type of diet is more effective

Question 16

The likelihood of developing chronic hepatitis B infection is increased in:
Select one:
a. those who contract it at a young age
b. those who contract it in their 50’s

Answer 16

a. those who contract it at a young age

Question 17

Diagnosis of cirrhosis is made by liver ultrasound.
Select one:
True
False

Answer 17

False

Percutaneous liver biopsy is required to make the diagnosis of cirrhosis.

Question 18

What is the medical term for a patient with confusion or altered mental status due to liver injury/disease?

Answer 18

Hepatic encephalopathy

Question 19

Which of the following blood tests is used in conjunction with ultrasound to screen for hepatocellular carcinoma?
Select one:
a. transaminases (AST/ALT)
b. alphafetoprotein (AFP)

Answer 19

b. alphafetoprotein (AFP)

Question 20

The incidence of hepatocellular carcinoma has been increasing in the United States?
Select one:
True
False

Answer 20

True

In large part due to the increasing incidence of NAFLD > cirrhosis > increased risk of hepatocellular carcinoma.