1.
Which of the following is NOT a liver function?
Correct Answer
B. Conversion of conjugated bili to unconjugated bili
Explanation
The liver performs various functions, including the conversion of excess glucose into glycogen for storage, regulation of blood coagulation, production of bile salts, and conversion of ammonia to urea. However, the conversion of conjugated bilirubin to unconjugated bilirubin is not a liver function. Conjugated bilirubin is already processed and ready for excretion, while unconjugated bilirubin needs to be further processed before it can be eliminated from the body.
2.
What is the maximum amount of cells the liver can have damaged or lost before failing to function?
Correct Answer
D. 3/4
Explanation
The maximum amount of cells the liver can have damaged or lost before failing to function is 3/4. This means that if 3/4 or more of the liver cells are damaged or lost, the liver will no longer be able to carry out its functions effectively.
3.
Bile by-products ultimately leave the body through ________, and blood by-products ultimately leave the body through ________.
Correct Answer
D. Feces, urine
Explanation
Bile is produced by the liver and stored in the gallbladder. It helps in the digestion of fats. After being used in the digestion process, bile by-products are eliminated from the body through the feces. On the other hand, blood by-products, such as waste products and excess water, are filtered by the kidneys and eliminated through the urine. Therefore, the correct answer is feces, urine.
4.
What substance that the liver synthesizes determines plasma oncotic pressure?
Correct Answer
C. Albumin
Explanation
Albumin is a protein synthesized by the liver that plays a crucial role in maintaining plasma oncotic pressure. Plasma oncotic pressure is the pressure exerted by proteins, primarily albumin, in the blood vessels that helps to retain fluid within the blood vessels. Albumin helps to prevent fluid from leaking out of the blood vessels into the surrounding tissues. Therefore, albumin is the substance synthesized by the liver that determines plasma oncotic pressure.
5.
What substance synthesized by the liver is mainly made up of cholesterol?
Correct Answer
D. Bile salts
Explanation
Bile salts are synthesized by the liver and are mainly made up of cholesterol. Bile salts play a crucial role in the digestion and absorption of dietary fats. They help in the emulsification of fats, which increases their surface area and allows for better digestion by enzymes. Bile salts also aid in the absorption of fat-soluble vitamins. Therefore, bile salts are an important component of bile, which is produced by the liver and stored in the gallbladder before being released into the small intestine to aid in digestion.
6.
What substance is associated with Wilsons disease because it is a copper-carrying protein?
Correct Answer
C. Ceruloplasmin
Explanation
Ceruloplasmin is associated with Wilson's disease because it is a copper-carrying protein. Wilson's disease is a genetic disorder that causes copper to accumulate in the body, leading to copper toxicity. Ceruloplasmin plays a crucial role in regulating copper levels in the body by binding to copper and transporting it. In individuals with Wilson's disease, there is a defect in the gene that produces ceruloplasmin, resulting in impaired copper transport and accumulation of copper in various organs, particularly the liver and brain.
7.
The liver synthesizes and excretes VLDL.
Correct Answer
A. True
Explanation
The liver is responsible for synthesizing and excreting VLDL, which stands for very low-density lipoprotein. VLDL is a type of lipoprotein that transports triglycerides from the liver to other tissues in the body. This statement is true because the liver plays a crucial role in lipid metabolism and is involved in the production and secretion of various lipoproteins, including VLDL.
8.
What is the name of the protease inhibitor that inactivates other proteases that cause inflammation?
Correct Answer
D. AlpHa1-antitrypsin
Explanation
Alpha1-antitrypsin is a protease inhibitor that inactivates other proteases responsible for causing inflammation. It helps to regulate the activity of enzymes involved in the breakdown of proteins, particularly in the lungs. Alpha1-antitrypsin deficiency can lead to lung damage and emphysema, as the uncontrolled protease activity can cause tissue destruction.
9.
The hepatocellular disease is associated with increased serum concentration of coagulation factors.
Correct Answer
B. False
Explanation
The statement is false. Hepatocellular disease is actually associated with decreased serum concentration of coagulation factors. This is because the liver plays a crucial role in producing clotting factors, and when it is damaged, the production of these factors is impaired, leading to decreased levels in the blood.
10.
What is the normal liver span?
Correct Answer
D. 6-12cm
Explanation
The normal liver span is typically between 6-12cm. This measurement refers to the distance between the upper and lower borders of the liver when it is palpated or felt during a physical examination. A liver span outside of this range may indicate an abnormality or pathology in the liver.
11.
Enlargement can be from focal lesions, which of the following is an example of a focal lesion?
Correct Answer
B. Cysts
Explanation
Cysts are an example of a focal lesion. Focal lesions refer to abnormalities or changes that are localized to a specific area or region within the body. Cysts are fluid-filled sacs that can develop in various parts of the body and are considered focal lesions because they typically occur in a specific location rather than affecting the entire body.
12.
If the AST/ALT ratio is >1, this is a possible sign of:
Correct Answer
A. Alcoholic cirrhosis
Explanation
An AST/ALT ratio greater than 1 suggests alcoholic cirrhosis. This is because in alcoholic cirrhosis, the AST levels are typically higher than the ALT levels, resulting in an elevated ratio. The ratio is often used as a marker to differentiate alcoholic liver disease from other causes of liver damage such as acute hepatitis, viral hepatitis, or mononucleosis with hepatitis, where the ratio is usually less than 1 or closer to 1.
13.
An AST/ALT ratio <1 could be indicative of:
Correct Answer
B. Mononucleosis with hepatitis
Explanation
An AST/ALT ratio
14.
True or false. The AST/ALT ratio is less accurate if AST>10x normal.
Correct Answer
A. True
Explanation
The AST/ALT ratio is less accurate when AST levels are extremely elevated, specifically when AST is greater than 10 times the normal range. This means that in cases where AST levels are significantly higher than normal, the AST/ALT ratio may not provide an accurate indication of liver function.
15.
Canalicular enzymes help to diagnose biliary obstruction. Which of the following is a canicular enzyme?
Correct Answer
C. Alkaline pHospHatase
Explanation
Alkaline phosphatase is a canalicular enzyme. Canalicular enzymes are enzymes that are found in the bile canaliculi, which are small ducts that transport bile from the liver to the gallbladder and small intestine. Alkaline phosphatase is one of the enzymes that is produced by the liver and is involved in the metabolism of bile. Elevated levels of alkaline phosphatase in the blood can indicate biliary obstruction, as the enzyme is released into the bloodstream when the flow of bile is blocked. Therefore, alkaline phosphatase is a useful marker for diagnosing biliary obstruction.
16.
Which of the following is NOT a canalicular enzyme?
Correct Answer
A. AlpHa1-antitrypsin
Explanation
Alpha1-antitrypsin is not a canalicular enzyme because it is primarily synthesized in the liver and secreted into the bloodstream, rather than being transported into the bile canaliculi. Canalicular enzymes, on the other hand, are enzymes that are synthesized in the liver and transported into the bile canaliculi, where they play a role in the formation of bile. Examples of canalicular enzymes include alkaline phosphatase, gamma-glutamyltransferase (GGT), and 5'-nucleotidase.
17.
Where is alkaline phosphatase mainly found?
Correct Answer
C. Bone and liver
Explanation
Alkaline phosphatase is mainly found in bone and liver. It is an enzyme that is involved in various important biological processes such as bone mineralization and liver function. In bone, alkaline phosphatase plays a crucial role in the formation and remodeling of bone tissue. In the liver, it is involved in the metabolism and detoxification of various substances. Therefore, the presence of alkaline phosphatase in both bone and liver makes it the correct answer.
18.
Heme oxygenation releases ______ & _______.
Correct Answer
C. Iron, biliverdin
Explanation
Heme oxygenation is the process of breaking down heme, a component of hemoglobin, and releasing its constituents. One of the products released is iron, which can be recycled and used for various physiological processes. The other product released is biliverdin, which is further converted into bilirubin and plays a role in the breakdown of red blood cells.
19.
Unconjugated bilirubin travels to the liver via plasma, bound to what?
Correct Answer
C. Albumin
Explanation
Unconjugated bilirubin, which is a waste product of red blood cell breakdown, is insoluble in water and therefore needs to be transported to the liver for further processing. It binds to albumin, a protein found in the plasma, for transport. Albumin acts as a carrier molecule, allowing the unconjugated bilirubin to be transported safely to the liver where it can be conjugated and eventually eliminated from the body. Transferrin is responsible for transporting iron, VLDL carries triglycerides, and ferritin stores iron, none of which are involved in the transport of unconjugated bilirubin.
20.
True or false. Unconjugated bilirubin is a hydrophillic toxin.
Correct Answer
B. False
Explanation
Unconjugated bilirubin is actually a hydrophobic toxin. It is produced during the breakdown of red blood cells and is transported to the liver where it is conjugated with glucuronic acid to form conjugated bilirubin. Conjugated bilirubin is then excreted in bile and eliminated from the body. Unconjugated bilirubin is not soluble in water and needs to be bound to albumin for transport in the blood. It can only become toxic when its levels are excessively high or when it is not properly processed by the liver.
21.
Which type of bilirubin can cross the blood brain barrier and cause kernicterus?
Correct Answer
A. Unconjugated
Explanation
Unconjugated bilirubin is the correct answer because it is the form of bilirubin that can cross the blood-brain barrier and cause kernicterus. Kernicterus is a neurological condition that occurs when unconjugated bilirubin levels in the blood are too high, leading to the deposition of bilirubin in the brain. Conjugated bilirubin, on the other hand, is unable to cross the blood-brain barrier and does not cause kernicterus.
22.
High amounts of what substance makes urine a dark tea-color?
Correct Answer
A. Conjugated bilirubin
Explanation
Conjugated bilirubin is the correct answer because it is a substance that can cause urine to appear dark tea-color. Bilirubin is a yellow pigment that is produced when red blood cells break down. In the liver, bilirubin is conjugated with glucuronic acid, which makes it soluble in water and allows it to be excreted in the urine. When there is a high amount of conjugated bilirubin in the urine, it can give it a dark tea-color. Unconjugated bilirubin, on the other hand, is not soluble in water and is typically excreted in the feces, so it does not contribute to the color of urine.
23.
In newborn jaundice, the baby is placed under "bili-lights" which prove to be an effective treatment. How does this process help?
Correct Answer
B. The unconjugated bilirubin absorbs the light and becomes water-soluble
Explanation
The bili-lights used in newborn jaundice treatment work by causing the unconjugated bilirubin to absorb the light. This absorption process helps to convert the unconjugated bilirubin into a water-soluble form, which can then be excreted from the body.
24.
WHat is the most common form of hyperbilirubinemia?
Correct Answer
C. Gilbert's Syndrome
Explanation
Gilbert's Syndrome is the most common form of hyperbilirubinemia. It is a benign condition characterized by elevated levels of unconjugated bilirubin in the blood. This occurs due to a deficiency in the enzyme responsible for bilirubin metabolism. The syndrome is typically asymptomatic, but individuals may experience intermittent jaundice or mild fatigue. It is important to note that Gilbert's Syndrome does not cause any serious health problems or liver damage.
25.
Gilbert's syndrome is a problem with what enzyme?
Correct Answer
B. Glucuronyl transferase
Explanation
Gilbert's syndrome is a genetic disorder that affects the liver's ability to process bilirubin, a waste product of red blood cell breakdown. Glucuronyl transferase is the enzyme responsible for conjugating bilirubin with glucuronic acid, making it water-soluble and allowing it to be excreted in the bile. A deficiency or dysfunction of this enzyme leads to an accumulation of unconjugated bilirubin in the blood, resulting in the characteristic symptoms of Gilbert's syndrome, such as jaundice.
26.
True or false. Gilbert's syndrome is a medical emergency and could be deadly.
Correct Answer
B. False
Explanation
Gilbert's syndrome is a benign and relatively common condition that affects the liver's ability to process bilirubin. It is not a medical emergency and is not considered deadly. People with Gilbert's syndrome may experience occasional mild jaundice, but it does not typically cause any serious health problems.
27.
GIlbert's syndrome is a problem with conjugated or unconjugated bilirubin?
Correct Answer
B. Unconjugated
Explanation
Gilbert's syndrome is a genetic condition that affects the liver's ability to process bilirubin, a yellow pigment produced when red blood cells break down. In this syndrome, there is a defect in the enzyme responsible for conjugating bilirubin, causing an increase in unconjugated bilirubin levels in the blood. Therefore, the correct answer is unconjugated.
28.
What manifestation is usually a result of liver or biliary tract disease?
Correct Answer
A. Conjugated hyperbilirubinemia
Explanation
Conjugated hyperbilirubinemia is a manifestation that is usually a result of liver or biliary tract disease. This condition occurs when there is an excess of bilirubin, a yellow pigment produced by the breakdown of red blood cells, in the bloodstream. In liver or biliary tract disease, the liver is unable to properly process and excrete bilirubin, leading to its accumulation in the blood. This can cause symptoms such as yellowing of the skin and eyes (jaundice) and dark urine. Therefore, conjugated hyperbilirubinemia is the correct answer.
29.
What causes impaired excretion of conjugated bilirubin?
Correct Answer
D. Cholestasis
Explanation
Impaired excretion of conjugated bilirubin is caused by cholestasis. Cholestasis refers to a condition where there is a reduction or blockage in the flow of bile from the liver. This can occur due to various reasons such as liver diseases, gallstones, or obstruction of the bile ducts. When cholestasis occurs, bilirubin, which is a waste product formed from the breakdown of red blood cells, cannot be properly excreted from the body. As a result, it accumulates in the blood, leading to jaundice and other symptoms associated with liver dysfunction.
30.
Which of the following are causes for intrahepatic cholestasis?
Correct Answer
C. Viral hepatitis
Explanation
Viral hepatitis can cause intrahepatic cholestasis. Hepatitis viruses can infect and inflame the liver, leading to impaired bile flow and accumulation of bile acids in the liver. This can result in cholestasis, which is characterized by the reduced secretion of bile into the digestive system. Other causes of intrahepatic cholestasis, such as gallstones, bile duct carcinoma, and cholangitis, are not mentioned in the question.
31.
Which of the following are causes for extrahepatic cholestasis?
Correct Answer
B. Cholangitis
Explanation
Cholangitis is inflammation of the bile ducts, which can lead to obstruction and extrahepatic cholestasis. This condition can cause a backup of bile in the liver, leading to symptoms such as jaundice and itching. Cirrhosis, viral hepatitis, and drug toxicity can also cause liver damage, but they may not directly result in extrahepatic cholestasis.
32.
True or false. Wilson's disease is when the liver has trouble with copper absorption.
Correct Answer
B. False
Explanation
Wilson's disease is a genetic disorder that causes excessive accumulation of copper in the body, not trouble with copper absorption in the liver. The liver is unable to excrete copper into bile, leading to its buildup in various organs such as the liver, brain, and other tissues. This can result in liver damage, neurological problems, and other symptoms. Therefore, the correct answer is false.
33.
What disease process manifests with Kayser-Fleischer rings around the corneas?
Correct Answer
D. Wilson's disease
Explanation
Wilson's disease is a genetic disorder that causes the body to retain copper, leading to its accumulation in various organs, including the liver, brain, and corneas. Kayser-Fleischer rings are a characteristic finding in Wilson's disease, which are brownish-green rings that form around the corneas due to copper deposition. This symptom is helpful in diagnosing Wilson's disease and differentiating it from other liver diseases like hepatitis or cirrhosis. Charlie's syndrome is not a recognized medical condition, making it an incorrect option.
34.
What are Kayser-Fleischer rings?
Correct Answer
D. Brown circles around the cornea
Explanation
Kayser-Fleischer rings are brown circles around the cornea. These rings are caused by the deposition of copper in the Descemet membrane of the cornea. They are a characteristic feature of Wilson's disease, a genetic disorder that affects copper metabolism in the body. The accumulation of copper in the cornea leads to the formation of these brown circles, which can be seen during an eye examination. Therefore, the correct answer is brown circles around the cornea.
35.
What is hemochromatosis?
Correct Answer
B. Iron storage disorder
Explanation
Hemochromatosis is a condition characterized by excessive iron absorption and accumulation in the body. This leads to iron overload and can result in damage to various organs, including the liver, heart, and pancreas. It is not related to white blood cell maturation, malformation of red blood cells, or inflammation of red blood cells. Therefore, the correct answer is "iron storage disorder."
36.
______ in the heart muscle may cause dilated cardiomyopathy and may lead to arrhythmia?
Correct Answer
C. Iron
Explanation
Iron overload in the heart muscle may cause dilated cardiomyopathy and may lead to arrhythmia. Excessive iron accumulation can lead to oxidative stress, inflammation, and fibrosis in the heart, leading to the dilation of the heart chambers and impaired cardiac function. This can disrupt the normal electrical conduction system of the heart, resulting in arrhythmias. Iron overload can occur in conditions such as hereditary hemochromatosis or as a result of repeated blood transfusions. Treatment involves reducing iron levels through phlebotomy or iron chelation therapy.
37.
What disease process may manifest as gonadal atrophy in men and amenorrhea in women?
Correct Answer
C. Hemochromotosis
Explanation
Hemochromatosis is a disease process characterized by the excessive accumulation of iron in the body. In men, this can lead to gonadal atrophy, which is the shrinkage of the testes and decreased production of hormones. In women, it can cause amenorrhea, which is the absence of menstrual periods. Therefore, hemochromatosis can manifest as both gonadal atrophy in men and amenorrhea in women.
38.
What substance is common in toxin-induced hepatotoxicity?
Correct Answer
C. Amanita pHalloides
Explanation
Amanita phalloides is a type of mushroom that contains a toxin called amatoxin. This toxin is known to cause hepatotoxicity, which is liver damage. When ingested, the toxin targets liver cells and disrupts their normal function, leading to liver injury. This is why amanita phalloides is commonly associated with toxin-induced hepatotoxicity. The other substances listed, such as oral contraceptives, valproic acid, rosarita sicca, and acetaminophen, may have hepatotoxic effects in certain situations, but they are not specifically known for causing toxin-induced hepatotoxicity.
39.
What storage, if exceeded in the liver, due to acetaminophen intake could be dangerous?
Correct Answer
D. Glutathione
Explanation
Excessive intake of acetaminophen can lead to the depletion of glutathione storage in the liver. Glutathione is an important antioxidant that helps protect liver cells from oxidative damage. When glutathione levels are depleted, it can lead to liver toxicity and damage. Therefore, exceeding the storage capacity of glutathione in the liver due to acetaminophen intake can be dangerous.
40.
What drug is given to reverse damage done by acetaminophen intake?
Correct Answer
D. N-acetylcysteine
Explanation
N-acetylcysteine is given to reverse damage done by acetaminophen intake. Acetaminophen, also known as paracetamol, can cause liver damage if taken in excessive amounts. N-acetylcysteine is a medication that helps replenish glutathione, an antioxidant that protects the liver from damage. By providing additional glutathione, N-acetylcysteine helps to counteract the toxic effects of acetaminophen and prevent further damage to the liver.
41.
Which form of hepatitis is self limiting, will not incur a carrier state or chronic disease state?
Correct Answer
B. A
Explanation
Hepatitis A is a form of hepatitis that is self-limiting, meaning it resolves on its own without treatment. It does not lead to a carrier state or chronic disease state. Hepatitis A is typically transmitted through contaminated food or water, and symptoms may include fatigue, nausea, and jaundice. Vaccination is available to prevent hepatitis A infection.
42.
Which hepatitis causes acute hepatitis but 95% of people clear the virus, but may be carriers?
Correct Answer
A. B
Explanation
Hepatitis B is the correct answer because it is known to cause acute hepatitis, but in 95% of cases, the body is able to clear the virus on its own. However, some individuals may become carriers of the virus, meaning that they can still transmit it to others even if they do not display symptoms themselves.
43.
True or false. Those with Hepatitis B may be at greater risk for hepatocellular carcinoma.
Correct Answer
A. True
Explanation
Hepatitis B is a viral infection that affects the liver and can cause chronic liver disease. Individuals with chronic hepatitis B infection are at a higher risk of developing hepatocellular carcinoma, which is the most common type of liver cancer. This is because the hepatitis B virus can cause inflammation and damage to the liver cells over time, increasing the likelihood of cancerous cell growth. Therefore, it is true that those with Hepatitis B may be at greater risk for hepatocellular carcinoma.
44.
Is hepatitis B cause by an RNA or DNA virus?
Correct Answer
B. DNA
Explanation
Hepatitis B is caused by a DNA virus. The hepatitis B virus (HBV) belongs to the Hepadnaviridae family, which is a group of enveloped DNA viruses. The virus contains a partially double-stranded DNA genome, and it replicates through reverse transcription, a process in which the viral RNA is converted into DNA. This DNA is then integrated into the host cell's genome, leading to chronic infection in some cases. Therefore, the correct answer is DNA.
45.
How is hepatitis B contracted?
Correct Answer
B. Blood or other body fluids
Explanation
Hepatitis B is contracted through blood or other body fluids. This includes contact with infected blood, semen, vaginal fluids, and saliva. The virus can be transmitted through sexual contact, sharing needles or other drug paraphernalia, and from mother to child during childbirth. It is important to practice safe sex, avoid sharing needles, and get vaccinated to prevent the transmission of hepatitis B.
46.
What is the earliest marker for acute infection in hepatitis B?
Correct Answer
D. HBsAg
Explanation
The earliest marker for acute infection in hepatitis B is HBsAg. HBsAg stands for hepatitis B surface antigen, which is a protein on the surface of the hepatitis B virus. It can be detected in the blood before symptoms of infection appear and before other markers such as ALT (alanine aminotransferase), IgG (immunoglobulin G), or HBeAg (hepatitis B e antigen) become detectable. Therefore, HBsAg is considered the earliest and most reliable marker for acute hepatitis B infection.
47.
What are the core antigens for Hepatitis B?
Correct Answer
E. Both C&D
Explanation
The core antigens for Hepatitis B are HCcAg and HBcAg. HCcAg refers to Hepatitis B core antigen, which is a viral protein found in the core of the virus. HBcAg, on the other hand, stands for Hepatitis B core antigen, and it is also a viral protein that is essential for the replication of the virus. Therefore, the correct answer is "Both C&D" as both HCcAg and HBcAg are core antigens for Hepatitis B.
48.
How is Hepatitis C contracted?
Correct Answer
C. Percutaneous/mucosal exposure to blood or blood products
Explanation
Hepatitis C is contracted through percutaneous/mucosal exposure to blood or blood products. This means that the virus can be transmitted through activities such as sharing needles, receiving blood transfusions or organ transplants from infected individuals, or having unprotected sex with someone who is infected. It is not contracted through feces or alcohol consumption.
49.
Is Hepatitis C a DNA/RNA virus?
Correct Answer
B. RNA
Explanation
Hepatitis C is caused by the Hepatitis C virus (HCV), which is an RNA virus. RNA viruses have RNA as their genetic material, unlike DNA viruses which have DNA. Therefore, the correct answer is RNA.
50.
What percentage of HCV infections become chronic?
Correct Answer
C. 60-85%
Explanation
The correct answer is 60-85%. This means that a significant majority of HCV infections become chronic. Chronic HCV infection occurs when the virus persists in the body for a prolonged period, usually more than 6 months. This high percentage indicates the potential for long-term health complications associated with chronic HCV, such as liver damage, cirrhosis, and even liver cancer. It emphasizes the importance of early detection, prevention, and treatment of HCV to reduce the risk of chronic infection and its consequences.