Week 13- Hepatobiliary disease Flashcards
Autoimmune hepatitis is when the body produces an inappropriate immune response against itself; sometimes develops ——against own liver tissue.
a) Antibodies
b) Antigens
a) Antibodies
Liver cirrhosis could be / regarded to:
Alcoholism
Hepatitis
Obstruction of bile ducts
a) True
b) False
a) True
Liver disease could be / regarded to: Genetic Hepatitis Infections Obstruction of bile ducts
a) True
b) False
a) True
Which of the following are markers for hepatocellular damage? Albumin ALP ALT AST Bilirubin LDH yGT Prothrombin
a) Albumin, ALP, AST and ALT
b) Bilirubin, ALP, AST and ALT
c) ALT, AST, ALP, yGT
d) LDH, ALP, AST, yGT
e) LDH, ALP, AST and ALT
c) ALT, AST, ALP, yGT
The marker for liver excretory function is
a) Albumin
b) Bilirubin
c) ALT
d) AST
e) LDH
b) Bilirubin
The marker for liver synthesis function is
a) Albumin
b) ALP
c) ALT
d) AST
e) Bilirubin
a) Albumin
The marker for hepatocellular damage is
a) Albumin
b) yGT
c) Bilirubin
b) yGT
ALT is present in many organs. So, why its elevation is a marker for liver disease? Because it is coming primarily from the ——.
a) Brain
b) Heart
c) Kidney
d) Liver
e) Pancreas
d) Liver
Serum ALT level, serum AST level, and their ratio (AST/ALT ratio) are commonly measured clinically as biomarkers for ——health.
a) Brain
b) Heart
c) Kidney
d) Liver
e) Pancreas
d) Liver
De Ritis Ratio is the ratio of Serum —– to ——.
a) ALT
b) AST
b) AST
a) ALT
De Ritis Ratio is used to differentiate between causes of hepatocellular damage or hepatotoxicity (e.g. alcoholic).
a) True
b) False
a) True
De Ritis Ratio is used to differentiate between cholestasis and hepatotoxicity (e.g. alcoholic).
a) True
b) False
b) False
- –is a more specific indicator of liverinflammationthan —, however, —often follows —.
a) ALT
b) AST
c) ALP
a) ALT
b) AST
b) AST
a) ALT
- –is a more specific indicator of liverinflammationthan —.
a) ALT
b) AST
a) ALT
Serum AST to ALT ratio of 2 or 3:1 is an indication for——.
a) Alcoholic liver disease
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia
a) Alcoholic liver disease
Liver —rises with obstruction or infiltrative diseases (i.e., stones or tumors) and this is why it is considered a marker for —-.
a) ALP
b) ALT
c) Alcoholic liver disease
d) Cholestasis
e) Glycemia
a) ALP
d) Cholestasis
An increase in ALP accompanied with normal GT, could be due to bone remodeling and pregnancy (3rd term)
a) True
b) False
a) True
An increase in ALP accompanied with normal GGT, is consistent with which of the following?
a) Alcohol or other drug induction
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia
c) Bone/skeletal diseases
An increase in GGT accompanied with normal ALP, and AST is consistent with which of the following?
a) Alcohol or other drug induction
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia
a) Alcohol or other drug induction
An increase in GGT and ALP is consistent with which of the following?
a) Alcohol or other drug induction
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia
b) Cholestasis
- —rises as a result of bone and liver diseases as well as cholestasis or drug/alcohol intake.
a) yGT
b) Bilirubin
c) Cholestasis
d) Glycemia
a) yGT
A rise in —is a sign of cholestasis, whereas, a rise in —— and normal —– is a sign of alcoholism/drugs.
a) ALP
b) Bilirubin
c) yGT
d) yGT and ALP
d) yGT and ALP
c) yGT
a) ALP
To differentiate between cholestasis and hepatocellular disease, if there are rise of yGT, ALT and AST and with normal-high ALP, it is a sign of ——–, whereas, if there are rise in yGT, ALP, with normal-high ALT and AST, it is a sign of ——–.
a) Cholestasis
b) Hepatocellular disease
b) Hepatocellular disease
a) Cholestasis
Bilirubin or unconjugated bilirubin is formed from the breakdown of —. It is then get —in the liver and —in the bile to the intestine.
a) Conjugated
b) Excreted
c) Glycogen
d) Heam
e) Hydrolysed
d) Haem
a) conjugated
b) excreted
The water —form of bilirubin needs to be converted to water —-form to be excreted.
a) Insoluble
b) Soluble
a) Insoluble
b) soluble
The enzyme UDP-glucuronosyl-transferase transforms ---------- to ----------. a) Albumin b) Conjugated bilirubin c) Haem d) Unconjugated bilirubin
d) Unconjugated bilirubin
b) conjugated bilirubin
Bilirubin or ——or indirect bilirubin is water —, whereas, —-or direct bilirubin is water –.
a) Conjugated bilirubin
b) Unconjugated bilirubin
c) Insoluble
d) Soluble
b) Unconjugated bilirubin
c) Insoluble
a) Conjugated bilirubin
d) Soluble
Gilbert’s syndrome causes ——- due to reduced activity of the enzyme
a) UDP-glucuronosyl-transferase.
b) Haemolysis
c) Cholestasis
d) Conjugated hyperbilirubinemia
e) Unconjugated hyperbilirubinemia
d) Conjugated hyperbilirubinemia
There is no direct bilirubin in urine.
a) True
b) False
b) False
RBCs in bone and spleen breakdown to produce —, which breaks down to bilirubin. Unconjugated bilirubin is transported via blood’s —to the liver.
In the liver, bilirubin gets conjugated via UDP glucuronosyl
transferase, then gets excreted via the bile duct to the —, where via the effect of certain bacteria, it forms stercobilinogen.
Stercobilinogen gets excreted in feces as stercobilin or reabsorbed by the —-to kidney and gets excreted in —as urobilin.
a) Albumin
b) Blood
c) Heam
d) Intestine
e) Urine
c) Haem
a) Albumin
d) Intestine
b) blood
e) urine
Jaundice is a syndrome characterised by ———and yellowish pigmentation of the sclerae, skin and mucous membrane.
a) Hypobilirubinemia
b) Hyperbilirubinemia
b) Hyperbilirubinemia
Jaundice could be regarded to increased —and consequently increased bilirubin secretion that exceeded the capacity of the —to remove it from the —.
a) Blood
b) Haemolysis
c) Kidney
d) Liver
e) Urine
b) haemolysis
d) Liver
a) blood
- ——is a condition where there is a decrease in thebile flow (blocked fully or partially) from theliverto theduodenum.
a) Cholestasis
b) Gilbert’s syndrome
c) Haemolysis
d) Hyperbilirubinemia
a) Cholestasis
Gilbert’s syndrome cause ——-due to reduced activity of the enzyme glucuronyltransferase, which conjugates bilirubin.
a) Haemolysis
b) Hyperbilirubinemia
c) Hypobilirubinemia
d) Obstruction of the bile duct
b) Hyperbilirubinemia
Jaundice is the result of hyperbilirubinemia. It could be the result of hepatic disease such as obstruction or cholestasis, also could be regarded to all the followings:
- Increased haemolysis
- Gilbert’s syndrome due to lack of gulcuronyltransferase, which conjugates bilirubin
- Cholestasis
- Obstruction of bile duct
a) True
b) False
a) True
The major protein synthesized by the ——is albumin.
a) Brain
b) Heart
c) Kidney
d) Liver
e) RBCs
d) Liver
The half life time of albumin is 20 days. That could be an indicator to differentiate between acute and chronic liver disease based on —-. If albumin remained low after 20 days, then it is —liver disease and if it returned back to normal, then it is —liver disease.
a) Acute
b) Chronic
c) Hypoalbuminemia
d) Hypomilirubinemia
c) Hypoalbuminemia
b) Chronic
a) Acute
A decrease in prothrombin could be seen in case of ——-jaundice due to lack in bile salt.
a) Hemolytic
b) Obstructive
a) Hemolytic
- — is fat soluble and it needs the bile salts for its absorption by the blood.
a) Vitamin A
b) Vitamin B
c) Vitamin C
d) Vitamin D
e) Vitamin K
e) Vitamin K
- —- is one of the earliest markers of decline in liver synthetic capacity and it has a shorter ½ life compared to other markers such as albumin. However, it needs vitamin —— for the coagulation process. In case there is haemorrhage, or diarrhoea, the vitamin becomes low in blood and patients need to be injected with the vitamin.
a) A
b) Albumin
c) C
d) K
e) Prothrombin time
e) Prothrombin time
d) K
The liver is responsible for the detoxification of —–by converting it to —(a product found in urine). Lack of this process, may end up with high ammonia in blood and that can cause hepatic comma.
a) Ammonia
b) Blood
c) Urea
d) Urine
a) Ammonia
c) urea
Checking —- is not a regular test in clinical lab, however, patients with severe liver disease may have this test to check the possibility of having hepatic comma (encephalopathy).
a) Albumin
b) Ammonia
c) Prothrombin
b) Ammonia
In some clinical labs, 5’ nucleotidase (5’NTD) is used as a substitute of —— for ascertaining whether an elevated ALP is of biliary or extra-biliary origin.
a) Albumin
b) ALP
c) Bilirubin
d) γGT
e) Prothrombin
d) yGT
Some of the genetic diseases of liver could be from —overload, haemochromatosis, or —overload, Wilson’s disease.
a) Copper
b) Iron
c) Potassium
d) Sodium
e) Zinc
b) Iron
a) Copper
Increased intestinal absorption of ——from the gastrointestinal tract is termed haemochromatosis:
a) Calcium
b) Copper
c) Haeme
d) Iron
e) Potassium
d) Iron
Why men are more vulnerable to haemochromatosis than women?
Because women have the menstruation.
a) True
b) False
a) True
Women are more likely to have hemochromatosis than men.
a) True
b) False
b) False
The preferred treatment of patients with hemochromatosis is:
a) Chelation of excess iron
b) Drinking too much fluids
c) Phlebotomy
c) Phlebotomy
Wilson’s disease is due to excess —— in the tissues due to lack of ceruloplasmin.
a) Calcium
b) Copper
c) Iron
d) Potassium
b) Copper
Alpha-1-antitrypsin inhibits a wide variety of —-. It protects tissues from enzymes of inflammatory cells. Alpha-1-antitrypsin could be detected from low alpha-1-antitrypsin level.
a) Oxidoreductases
b) Proteases
c) Transferases
d) Ligases
b) Proteases
Hepatitis is a breakdown of the person’s immune system due to viruses, alcohol, drugs or toxins leading to inflammation of the ——.
a) Heart
b) Kidney
c) Liver
d) Pancreas
e) Spleen
c) Liver
The stages of Hepatitis and liver damage are:
a) Cirrhosis – Fatty – Fibrosis
b) Fat accumulation – Fibrosis – Cirrhosis
c) Fibrosis – Fat accumulation – Cirrhosis
d) Fat accumulation – Cirrhosis – Fibrosis
e) Fibrosis – Cirrhosis - Fat accumulation
b) Fat accumulation – Fibrosis – Cirrhosis
- ——–: theliverdoes not function properly due to long-term damage.
a) Cirrhosis
b) Necrosis
a) Cirrhosis
- ——–: is a form ofcell injurywhich results in the prematuredeathofcellsin livingtissuebyautolysis.
a) Cirrhosis
b) Necrosis
b) Necrosis
Cirrhosisis a form ofcell injurywhich results in the prematuredeathofcellsin livingtissuebyautolysis.
a) True
b) False
b) False
In hepatitis, ALT and AST are higher in case of —hepatitis than —hepatitis
a) Alcoholic
b) Chronic
a) Alcoholic
b) Chronic
It is interesting to find more rise in ALT and AST in –viral hepatitis than alcoholic than —than cirrhotic liver cells. That could be regarded to the amount of good tissues to be lysed to release enzymes are —–in that order.
a) Acute
b) Chronic
c) Decreasing
d) Increasing
a) Acute
b) Chronic
c) decreasing
In hepatitis, ALT and AST are higher in case of —-hepatitis than —-hepatitis
a) Acute
b) Chronic
a) Acute
b) Chronic
Hepatic encephalopathy is the loss of —–function that occurs when the liver is unable to remove toxins from the blood.
a) Brain
b) Heart
c) Kidney
d) Muscles
e) Pancreas
a) Brain
Cirrhosis could be due to all of the following EXCEPT
a) Alcoholic
b) Biliary
c) Cardiac
d) Post necrotic or post viral Cirrhosis
e) Skeletal muscles
e) Skeletal muscles
A major cause of fatty liver is excessive —. Accumulation of fat may also be accompanied by a progressive inflammation of the liver (hepatitis), and this is termed —-
a) Albumin
b) Alcohol
c) AIDS
d) Steatohepatitis
e) Urea
b) Alcohol
d) Steatohepatitis
The following are primary causes of Non-alcoholic fatty liver disease: Diabetes mellitus (type II) Increased insulin resistance syndrome Hyperlipidemia Obesity
a) True
b) False
a) True
- ——–occurs when fat is deposited (steatosis) in the liver due to causes other than excessive alcohol use. It is now the most common cause of cryptogenic cirrhosis.
a) Alcoholic cirrhosis
b) Diabetes mellitus (type II)
c) Hyperlipidemia
d) Obesity
e) Non-alcoholic steatohepatitis
e) Non-alcoholic steatohepatitis
Hepatocellular carcinoma is the most common type of liver cancer.
a) True
b) False
a) True
The two specific tumour markers for hepatoma are:
- ——- and ———–
a) Albumin
b) Alpha fetoprotein
c) Hepatic ultrasound
d) Gamma GT
e) Prothrombin
b) Alpha fetoprotein
c) Hepatic ultrasound
