Liver 2

Question 1

L1: _____: antibody to HBsAg, marker of immunity to hepatitis B

Answer 1

HBsAb

Question 2

L1: _____: Hepatitis B surface antigen, marker of active inflamamation, presence for more than 6 months is used to define chronic hepatitis

Answer 2

HBsAg

Question 3

L1: _____: marker of current or prior Hepatitis B infection, antibody to core protein

Answer 3

HBcAb

Question 4

L1: Classification: _______: direct hyperbilirubinemia

Answer 4

Conjugated

Question 5

L1: Classification: _______: indirect hyperbilirubinemia

Answer 5

Unconjugated

Question 6

L1: What is a possible cause of AST/ALT ratio greater than 1?

Answer 6

Cirrhosis

Question 7

L1: Which infection is cleared with treatment: HBV or HCV?

Answer 7

HCV

Question 8

L1: Which liver function tests signifty cholestasis?

Answer 8

Alkaline Phosphatase, Bilirubin

Question 9

L1: Which liver function tests signify hepatocellular damage?

Answer 9

ALT and AST

Question 10

L1: Which pathologic pattern? 25-40% of neonatal cholestasis, sporadic and familial forms, diagnosis of exclusion

Answer 10

Idiopathic Neonatal Hepatitis

Question 11

L1: Which pathologic pattern? Most common malgnant primary liver tumor in patients

Answer 11

Hepatoblastoma

Question 12

L1: Which pathologic pattern? Most common malgnant primary liver tumor in patients >5 years old

Answer 12

Hepatocellular Carcinoma

Question 13

L1: Which pathologic pattern? Obstruction of extrahepatic biliary tree

Answer 13

Biliary Atresia

Question 14

L2: _____: associated with lower viral load of HBV

Answer 14

HBeAb

Question 15

L2: _____: presence signifies active viral hepatitis B replication

Answer 15

HBV DNA

Question 16

L2: _____: surrogate marker for high viral load of HBV

Answer 16

HBeAg

Question 17

L2: How is chronic HBV defined?

Answer 17

HBsAg more than 6 months

Question 18

L2: How is chronic HCV defined?

Answer 18

HCV RNA more than 6 months

Question 19

L2: Name 2 risk factors for hepatoblastoma

Answer 19

FAP, Beckwith-Wiedemann Syndrome

Question 20

L2: Treatment of autoimmune hepatitis

Answer 20

Corticosteroids and azathioprine

Question 21

L2: Treatment of hemochromatosis

Answer 21

Therapeutic Phlebotomy (Chelation therapy in anemic patients)

Question 22

L2: Treatment of Non-Alcoholic Steatohepatitis

Answer 22

Risk Factor Modification

Question 23

L2: Treatment of Primary Biliary Cirrhosis

Answer 23

Ursodeoxycolic Acid (UDCA)

Question 24

L2: Treatment of Primary Sclerosing Cholangitis

Answer 24

No medical therapy; manage duct complications

Question 25

L2: Treatment of Wilson Disease

Answer 25

Chelation Therapy (D-penicillamine or trientine); Zinc (maintenance therapy)

Question 26

L2: Treatment options for HBV

Answer 26

Interferon, Nucleotide(side) analogs

Question 27

L2: What is a possible cause of AST/ALT ratio greater than 2?

Answer 27

Alcoholic Liver Disease

Question 28

L2: What is the pathologic gene aberration in hepatoblastoma?

Answer 28

Wnt/Beta-catenin (80%)

Question 29

L2: What serum marker may be used in diagnosis of hepatoblastoma?

Answer 29

alpha-fetoprotein

Question 30

L2: Which hepatocellular LFT is located in the cytosol and mitochondria?

Answer 30

AST

Question 31

L2: Which hepatocellular LFT is located in the cytosol only?

Answer 31

ALT

Question 32

L2: Which hepatocellular LFT is most specific?

Answer 32

ALT

Question 33

L2: Which liver function test marker is expressed in the heart, muscle, and blood in addition to the liver?

Answer 33

AST

Question 34

L2: Which liver function test marker is expressed in the nearly all tissues with particular emphasis on bone?

Answer 34

Alkaline Phosphatase

Question 35

L2: Which pathologic pattern? Autosomal dominat mutation in bilirubin-UDP-glucuronosyltransferase (UGT1A1)

Answer 35

Type II Crigler-Najjar Syndrome

Question 36

L2: Which pathologic pattern? Autosomal recessive mutation in bilirubin-UDP-glucuronosyltransferase (UGT1A1), requires transplant

Answer 36

Type I Crigler-Najjar Syndrome

Question 37

L2: Which pathologic pattern? Biliary atresia due to genetic abnormality with jaundice at birth; associated developmental defects

Answer 37

Embryonic/Fetal Biliary Atresia

Question 38

L2: Which pathologic pattern? Biliary atresia with new onset progressive jaundice 1-6 weeks after birth; etiology unknown

Answer 38

Perinatal Biliary Atresia

Question 39

L2: Which pathologic pattern? Congenital abnormality of bile ducts resulting in dilatation and cholestasis

Answer 39

Choledochal Cyst

Question 40

L2: Which pathologic pattern? Hereditary defect in excretion of conjugated bilirubin due to mutation in MRP2; variable hyperbilirubinemia

Answer 40

Dubin-Johnson Syndrome

Question 41

L2: Which pathologic pattern? Most common indication for transplantation in pediatric patients

Answer 41

Biliary Atresia

Question 42

L2: Which pathologic pattern? Pain, jaundice, RUQ mass presenting prior to age 10

Answer 42

Choledochal Cyst

Question 43

L2: Which pathologic pattern? Unknown defect resulting in variable conjugated hyperbilirubinemia

Answer 43

Rotor Syndrome

Question 44

L2: Which pathologic pattern? Variable expression of UGT1A1 with recurrent stress-induced hyperbilirubinemia (seen in 5-10% of the population)

Answer 44

Gilbert Syndrome

Question 45

L3: Indication for HBV treatment

Answer 45

advanced liver disease or HBsAg more than 6 months with HBV DNA in serum and elevation of ALT or AST

Question 46

L3: Name 3 malignant pediatric liver tumors.

Answer 46

Hepatoblastoma, Hepatocellular carcinoma, Undifferentiated/Embryonal Sarcoma

Question 47

L4: Name 4 benign pediatric liver tumors.

Answer 47

Mesenchymal hamartoma, teratoma, hepatocelular adenoma, focal nodular hyperplasia

Question 48

L4: Name 4 causes of unconjugated/indirect hyperbilirubinemia

Answer 48

Gilbert's Disease, Crigler-Najjar Syndrome, Hemolysis, Cirrhosis

Question 49

L4: Name 4 non-hepatic causes of AST or ALT elevation less than 5 times normal

Answer 49

Vigorous exercise, hemolysis, thyroid disease, myopathy