Liver Flashcards
Which of the following condition is associated with unconjugated hyperbilirubinemia ? A. Dubin- Johnson syndrome B. Rotor syndrome C. Gilbert syndrome D. Gallstones
Answer - C. Gilbert syndrome
Causes of hyperbilirubinemia Unconjugated hyperbilirubinemia 1. Physiological jaundice of newborn 2. Hemolytic anemia 3. Diffuse hepatocellular disease 4. Crigglar-Najar syndrome 5. Gilbert syndrome
Conjugated hyperbilirubinemia
- Biliary tract obstruction
- Biliary tract disease like primary biliary cirrhosis and primary sclerosing cholangitis
- Dubin-Johnson syndrome
- Rotor syndrome
A patient with unconjugated bilirubinaemia has increased excretion of urobilinogen in his urine. This can be seen in all of the following conditions, except : A. G6PD deficiency B. Hemolytic anemia C. Hereditary spherocytosis D. Biliary cirrhosis
Answer - D. Biliary cirrhosis
Biliary cirrhosis is associated with conjugated hyperbilirubinemia
A 20 year old man with HbsAg +ve, HbeAg -ve with SGOT and SGPT raised 5 times the normal value. The HBV DNA copies are 1,00,000/ml. Which is the likely diagnosis A. Wild type HBV B. Surface mutant HBV C. Pre core mutant HBV D. Inactive HBV carrier
Answer- C. Precore mutant HBV
The pre core region directs the release of HbeAg towards secretion in the blood. Uncommonly, mutated strains called pre core mutants of HBV emerge that do not produce HbeAg but are viral competent and express HbcAg. In these patients, the HbeAg maybe undetectable despite the presence of HBV viral load.
Another mutation in the core promoter region can also lead to an HbeAg negative phenotype. Clinically both these conditions are characterized by the presence of elevated liver enzymes and active viral multiplication is indicated only by the high levels of DNA polymerase.
True about hemochromatosis is A. Complete penetrance B. Autosomal recessive C. Phlebotomy leads to cure D. More common in females
Answer- B. Autosomal recessive
Hemochromatosis is characterized by excessive accumulation of iron in the body.
It is an autosomal recessive disorder most commonly caused by mutations in HFE gene located in 6p21.3.
It is more common in males and is characterized by triad of
- Micronodular cirrhosis
- Diabetes mellitus
- Skin pigmentation
Most of the cells of the body has increased amounts of hemosiderin in them but skin pigmentation is primarily due to increased intracellular melanin.
Cardiac failure and hepatocellular carcinoma are the most common cause of death.
Which one of the following diseases characteristically causes fatty change in the liver? A. Hepatitis B virus infection B. Wilson's disease C. Hepatitis C infection D. Chronic alcoholism
Answer- D. Chronic alcoholism
Alcoholic liver disease is the most common cause of fatty liver.
Fatty liver is characteristically seen in chronic alcoholism. However many other causes of fatty liver also have been elucidated. These are therefore known as non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH)
