Noninfectious hepatobiliary disease

Question 1

what does INR test?

Answer 1

concentration of albumin and proteins in the blood

Question 2

what is the most important part of evaluation of patient with elevated LFTs?

Answer 2

history

Question 3

INR and albumin are indicative of what type of liver function?

Answer 3

synthetic function

Question 4

what are the stigmata of liver disease?

Answer 4

spider nevi 
palmar erythema 
gynecomastia 
caput medusa 
dupuytrens contracture 
parotid gland enlargement 
testicular atrophy 
asterixis 
virchows node 
sister mary joseph nodule 
right pleural effusion 
jugular venous distension

Question 5

what sign is indicative of hepatic congestion?

Answer 5

jugular venous distension

Question 6

in alcoholic liver disease what is the ratio of AST:ALT?

Answer 6

2:1

Question 7

GGT is induced by what?

Answer 7

alcohol

Question 8

how is the etiology of ascites determined?

Answer 8

serum ascites - albumin ratio

more than 1.1 - portal HTN
less than 1.1 - no portal HTN

Question 9

what is the treatment for maintaining an appropriate electrolyte balance in alcoholic liver disease?

Answer 9

spironolactone and furosimide

Question 10

what drugs should be avoided in alcoholic liver disease?

Answer 10

NSAIDs

Question 11

what is the treatment for hepatic encephalopathy? what is the mechanism?

Answer 11

titrate lactulose

changes colonic pH

Question 12

what is a major complication of alcoholic liver disease?

Answer 12

spontaneous bacterial peritonitis

Question 13

what is the threshold for neutrophil count requiring paracentesis in spontaneous bacterial peritonitis?

Answer 13

250 or greater

Question 14

what is the treatment of choice for esophageal varices?

Answer 14

endoscopic therapy (scleropathy, banding)

Question 15

what type of beta blockers can be used for esophageal varices?

Answer 15

nonselective

propanalol

Question 16

what is the discriminant function used for?

Answer 16

alcoholic hepatitis

Question 17

in hemochromatosis what color is the skin?

Answer 17

gray

Question 18

hemochromatosis carries a 25-30% risk of development of what disease?

Answer 18

hepatocellular cancer

Question 19

in diagnosing hemachromatosis what is the transferrin saturation level?

Answer 19

over 45%

Question 20

what is NASH?

Answer 20

fat accumulation to hepatic steatosis with inflammatory component

leads to fibrosis and cirrhosis

Question 21

what is the ALT to AST ratio in NAFLD?

Answer 21

ALT greater than AST

Question 22

what vitamin can be given for NAFLD?

Answer 22

vitamin E

Question 23

what test is most useful to determine autoimmune liver disease?

Answer 23

SPEP

Question 24

gilbert syndrome is due to what cause?

Answer 24

reduced enzyme activity

Question 25

what type of bilirubin is involved in gilbert syndrome? is there hemolysis?

Answer 25

unconjugated bilirubin

no evidence of hemolysis

Question 26

gilbert syndrome affects what population?

Answer 26

young white males

Question 27

men 
jaundice 
UC 
increase ALP 
beaded appearance of bile ducts

Answer 27

primary sclerosing cholangitis

Question 28

women
increased ALP
positive AMA

Answer 28

primary biliary cirrhosis