Quiz 1 Flashcards
Your patient presents with jaundice, severe epigastric pain, nausea, and vomiting. Ultrasound indicates what is likely a large cholesterol stone obstructing his common bile duct. Which of the following laboratory patterns is the most characteristic of this presentation?
Question 1 Answer
a.
Greatly elevated direct bilirubin, mildly elevated indirect bilirubin, greatly elevated ALP, mildly elevated ALT
b.
Greatly elevated indirect bilirubin, mildly elevated direct bilirubin, greatly elevated ALP, mildly elevated ALT
c.
Greatly elevated direct bilirubin, mildly elevated indirect bilirubin, greatly elevated ALT, mildly elevated ALP
d.
Greatly elevated indirect bilirubin, mildly elevated direct bilirubin, greatly elevated ALT, mildly elevated ALP
a
Which of the following is a criterion for the diagnosis of MAFLD?
Question 2 Answer
a.
A 2% level of hepatic steatosis
b.
Regular alcohol use
c.
Increased LDL
d.
Type II diabetes
d
Which of the following hormones is most likely to be decreased in someone with MAFLD?
Question 3 Answer
a.
Leptin
b.
Angiotensin 2
c.
Insulin
d.
Adiponectin
d
Which of the following laboratory findings would most likely indicate hepatocellular injury?
Question 4 Answer
a.
Elevated ALP levels only
b.
Elevated ALT and AST levels
c.
Elevated AST levels only
d.
Elevated ALP and bilirubin
b
Insulin resistance is often associated with obesity. Choose the FALSE statement about the pathophysiologic link between insulin resistance and obesity.
(2 answers)
a.
Those with higher visceral fat release increased concentrations of GLP-1, which can reduce satiety and lead to insulin resistance due to increased feeding activity
b.
Inflammatory cytokine release in obesity is linked to insulin resistance.
c.
Obesity is associated with reductions in adiponectin, and this contributes to insulin resistance
d.
Obesity is associated with reductions in retinol-binding protein 4, and this contributes to insulin resistance
a and d
Which of the following activities would be defined as EAT, but not NEAT?
Question 6 Answer
a.
A student dances at a club for 2 hours on a Saturday night.
b.
A person goes on a 2 km warm-up run as part of a kickboxing training regimen.
c.
You go hiking for an hour with your dog.
d.
A farmer moves 200 kg of hay bales in 15 minutes.
b
When a person loses weight due to caloric restriction alone (i.e. no increase in exercise), then that person tends to use less calories for a given physical task than prior to weight loss. For example - prior to dieting the subject burned 100 calories by walking up 15 flights of stairs, but after dieting she only burned 80 calories after climbing 15 flights of stairs.
What is the most likely reason for this?
Question 7 Answer
a.
After weight loss decreases in circulating leptin reduce energy use in skeletal muscle
b.
After weight loss there is markedly decreased activity of the parasympathetic nervous system.
c.
After weight loss skeletal muscle becomes more efficient
d.
After weight loss the subject is more mobile with fewer restrictions in movements
c
Which of the following is TRUE about resting metabolic rate (RMR)?
Question 8 Answer
a.
Obesity is associated with a lower RMR
b.
Women generally have higher RMR then men
c.
Most of the variation of RMR between individuals is attributable to the amount of fat free mass
d.
RMR generally does not contribute very much to daily energy expenditure
c
Which of the following is TRUE about the potential role of bile acids in improving obesity and obesity-related diseases:
Question 9 Answer
a.
Bile acids shift fatty acids stored in visceral adipose tissue to subcutanous adipose tissue.
b.
Bile acids reduce insulin secretion, therefore decreasing insulin resistance
c.
Bile acids promote GLP-1 secretion to reduce food intake
d.
Bile acids increase hepatic gluconeogenesis
c
Which of the following statements about the twin cycle hypothesis is CORRECT?
Question 10 Answer
a.
Excess lipids accumulate in pancreas which promotes somatostatin release
b.
Over time, insulin resistance improves the ability of adipocytes to store fat and FFA levels in the bloodstream decrease
c.
Excess lipids accumulate in hepatocytes as excess glycogen
d.
Excess lipids in hepatocytes promote insulin resistance
d
Insulin resistance is associated with:
Question 11 Answer
a.
Increased secretion of nitric oxide and prostacyclin by endothelial cells
b.
Increased reactive oxygen species and fibrosis within the heart
c.
Decreased bone density and osteoporosis
d.
Development of diabetic ketoacidosis long term
b
The twin cycle hypothesis suggests that alterations in lipid metabolism are responsible for the development of type 2 diabetes mellitus. Choose the lipid abnormality that is predicted by the twin cycle hypothesis.
Question 12 Answer
a.
Increased serum levels of free fatty acids
b.
Decreases in leptin secretion from subcutaneous adipocytes
c.
Elevations in HDL secretion by steatotic hepatocytes
d.
A decrease in VLDL secretion and an increase in LDL secretion
a
