Week 4 - Review Session

Question 1

True or false. Fatigue, weakness, nausea, poor
appetite, and malaise are common symptoms
of patients with hepatitis.

a. true
b. false

Answer 1

a. true

Hepatitis = liver inflammation

Question 2

What causes hepatitis?

Answer 2

Fatty liver
Alcohol
Medications
Viruses
Autoimmune
Genetic

Question 3

Which of these is a benign genetic disorder that results is mild jaundice typically during periods of stress?

a. carotenemia
b. Gilbert’s
c. hemolytic anemia

Answer 3

b. Gilbert’s

Question 4

Dark or tea colored urine can be suggestive of liver disease. What is causing the urine to be dark in a patient with liver disease?

A. Blood in the urine
B. Bilirubin in urine

Answer 4

B. Bilirubin in urine

Question 5

Which of the following stool colors is suggestive of liver disease?

a. green
b. light or clay colored
c. dark

Answer 5

b. light or clay colored

Pale = not getting bilirubin into the gut in the first place.

Question 6

What does pruritis mean?

a. pale stool
b. itchy skin
c. yellow eyes

Answer 6

b. itchy skin

Question 7

What does scleroicterus mean?

a. pale stool
b. itchy skin
c. yellow eyes

Answer 7

c. yellow eyes

Question 8

True or False. Patients who eat too much carotene typically have a uniform distribution of yellow discoloration in the skin including the eyes.

a. true
b. false

Answer 8

b. false

Jaundice affects the eyes. Carotenemia spares the eyes and most commonly shows up on the face, palms and soles.

Question 9

True or False. If a patient has jaundice you would expect to see an elevated bilirubin on blood work.

a. true
b. false

Answer 9

a. true

Question 10

[insert photo] What is this skin finding (suggestive of chronic liver disease) called?

a. spider angiomata
b. telangectasia
c. caput medusa

Answer 10

a. spider angiomata

Question 11

True or false. Spider angiomata only occur on
the face, legs, and abdomen.

a. true
b. false

Answer 11

b. false

Liver disease shows up in these areas. But spider veins have nothing to do with liver disease.

Question 12

Which medication is the #1 cause of acute
liver failure in the U.S.?

a. acetaminophen
b. APAP
c. Tylenol
d. paracetamol
e. all of the above are correct

Answer 12

e. all of the above are correct

Question 13

What is the maximum safe dose of acetaminophen per day?

a. 650mg
b. 1000mg
c. 4000mg
d. 8000mg

Answer 13

c. 4000mg

Question 14

Which of the following is the cardinal sign of
overt liver failure?

a. ascites
b. caput medusae
c. mental confusion
d. vomiting blood

Answer 14

c. mental confusion (hepatic encephalopathy)

Question 15

In a patient with advanced liver disease, you note that they have a flapping tremor on flexion of the wrists. What is this called?

a. carotenemia
b. asterixis
c. hepatic encephalopathy

Answer 15

b. asterixis

Question 16

Which lab test is most suggestive of hepatocellular injury?

a. AST
b. alkaline phosphatase

Answer 16

a. AST

If alkaline phosphatase is elevated, how do you know its liver related? Check GGT levels

Question 17

If a patient has an abnormal albumin level due to chronic liver disease, what would you expect to see on blood tests?

a. low albumin
b. high albumin

Answer 17

a. low albumin

Low albumin means low protein, and low protein in the blood leads to edema. When edema is in the belly we call it ascites.

Question 18

Which is more likely to show bilirubin deposition first?

a. eyes
b. skin

Answer 18

a. eyes

Question 19

True or false. Steatohepatitis in a non- alcoholic patient is synonymous with NASH.

a. true
b. false

Answer 19

a. true

Question 20

True or false. Steatosis refers to triglyceride
deposition and inflammation in the liver.

a. true
b. false

Answer 20

b. false

YES, Steatosis refers to triglyceride deposition. But it does not refer to inflammation in the liver (-ITIS).

Question 21

In order to diagnosis a patient with NAFLD, which of the following is true?

a. they must have evidence of fatty liver on liver biopsy
b. they must not drink any alcohol
c. you must rule out other causes, such as viral and autoimmune hepatitis

Answer 21

c. you must rule out other causes, such as viral and autoimmune hepatitis

DX or NAFLD is with ultrasound, not a biopsy. It is cirrhosis that is staged/Dx with biopsy.

Question 22

Which of the following is NOT equivalent to 1
drink of alcohol?

a. 8 ounces of wine
b. 12 ounces of beer
c. 1.5 ounces of liquor

Answer 22

a. 8 ounces of wine