Manifestations of Liver Disease

Question 1

Hepatocyte injury can be caused by………

Answer 1

viral infection, 
drugs or toxins, 
hypoxia, 
immunologic and structural disorders, or 
inborn errors of metabolism

Question 2

Cholestasis is defined ………..

Answer 2

An alternative or concomitant response to injury caused by extrahepatic or intrahepatic obstruction to bile flow.

Substances that are normally excreted in bile, such as bile acids, conjugated bilirubin, cholesterol, and trace elements, accumulate in serum

Question 3

In extrahepatic obstruction …..characteristics

Answer 3

Bile pigment may be visible in the intralobular bile ducts or throughout the parenchyma as bile lakes or infarcts

Question 4

Definition of Cirrhosis……

Answer 4

Cirrhosis, defined histologically by the presence of bands of fibrous tissue that link central and portal areas and form parenchymal nodules, is an end stage of any acute or chronic liver disease

Question 5

Type of cirrhosis ,……..?

Answer 5

Cirrhosis can be macronodular, with nodules of various sizes (up to 5 cm) separated by broad septa, or

micronodular, with nodules of uniform size (<1 cm) separated by fine septa;

mixed forms occur.

Question 6

When do u say henpatomegaly in neonate……

Answer 6

In a newborn infant, extension of the liver edge more than 3.5 cm below the costal margin in the right midclavicular line suggests hepatic enlargement

Question 7

jaundice in children and adults occurs when the serum concentration of bilirubin reaches….

Answer 7

2-3 mg/dL

Question 8

Pathogenicity of spider angiomas…..

Answer 8

They presumably reflect altered estrogen metabolism in the presence of hepatic dysfunction

Question 9

Palmar Erythema……..?

Answer 9

Abnormal serum estradiol levels and regional alterations in peripheral circulation have been identified as possible causes.

Question 10

Portal Hypertension…….? Definition

Answer 10

Normal portal pressure is between 1 and 5 mm Hg.

Portal hypertension is defined as a portal pressure greater than or equal to 6 mm Hg.

Clinically significant portal hypertension exists when pressure exceeds a threshold of 10-12 mm Hg

Question 11

Hepatorenal syndrome definition…….?

Answer 11

Hepatorenal syndrome is defined as functional renal failure in patients with end-stage liver disease.

Question 12

Pathophysiology of hepatorenal syndrome…..?

Answer 12

It is related to splanchnic vasodilation, mesenteric angiogenesis, and decreased effective blood volume with resulting decreased renal perfusion.

Question 13

The diagnosis is supported by the findings of….. in hepatorenal syndrome….?

Answer 13

oliguria (<1 mL/kg/day), a characteristic pattern of urine electrolyte abnormalities (urine sodium <10 mEq/L, fractional excretion of sodium of <1%, urine: plasma creatinine ratio <10, and normal urinary sediment), absence of hypovolemia, and exclusion of other kidney pathology

Question 14

The best treatment of hepatorenal syndrome…..?

Answer 14

Liver transplantation, with complete renal recovery expected.

Question 15

Hepatopulmonary syndrome (HPS) is characterized ……?

Answer 15

Triad of
hypoxemia,
intrapulmonary vascular dilations, and
liver disease

Question 16

Reason for HPS syndrome ……..?

Answer 16

Shunting of vasodilatory mediators from the mesentery away from the liver is thought to contribute

Question 17

Treatment for HPS……..?

Answer 17

Liver transplant

Question 18

Recurrent Cholangitis the most common cause…….?

Answer 18

Gram-negative enteric organisms such as Escherichia coli, Klebsiella, Pseudomonas, and Enterococcus

Question 19

Sensitive indicators of obstruction or inflammation of the biliary tract……..?

Answer 19

Elevations in serum AP, 5′ nucleotidase, and GGT levels

Question 20

Which is liver specific enzyme….?

Answer 20

Alanine aminotransferase (ALT, serum glutamate pyruvate transaminase)SGPT

Question 21

A several thousand–fold elevation of liver enzymes etiology……can result from

Answer 21

acute viral hepatitis,

toxic injury (e.g., acetaminophen),

hypoxia, or

hypoperfusion

Question 22

AST >ALT…….causes!

Answer 22

alcohol-induced liver injury,

fulminant echovirus infection, and

various metabolic diseases

Question 23

ALT>AST……causes. .?

Answer 23

Acute hepatitis

Question 24

AST and ALT elevations may be less marked in which conditions…….?

Answer 24

In chronic liver disease or

in intrahepatic and extra-hepatic biliary obstruction

Question 25

vitamin K–dependent factors …….

Answer 25

II, VII, IX, and X

Question 26

Persistently low levels of which factor are evidence of a poor prognosis in patients with fulminant liver disease

Answer 26

factor VII