LVR

Question 1

the remnant of the obliterated umbilical V and enters the left liver hilum at the front edge of Falciform Ligament

a. round ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament

Answer 1

A

Question 2

separates L lateral and L medial segments along the UMBILICAL FISSURE and anchors the liver to anterior abdominal wall.

a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament

Answer 2

A

Question 3

secures the two side of the liver to the diaphragm

a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
e. round ligament

Answer 3

B

Question 4

the anterior extensions from triangular ligaments. The R CL anchors the liver to R retroperitoneum

a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
e. round ligament

Answer 4

C

Question 5

contains porta hepatis

a. falciform ligament
b. triangular ligaments
c. coronary ligament
d. hepatoduodenal ligament
e. round ligament

Answer 5

D

Question 6

What percent of the liver is the right lobe?

Answer 6

60-70%

Question 7

R anterior lobe

a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII

Answer 7

C

Question 8

R posterior lobe

a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII

Answer 8

D

Question 9

Quadrate lobe

a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII

Answer 9

B

Question 10

Caudate lobe

a. Segment I
b. Segment IV
c. Segment V and VIII
d. Segment VI and VII

Answer 10

A

Question 11

Major blood supply of liver

a. Hepatic artery
b. Portal vein
c. celiac artery
d. Gastroduodenal artery

Answer 11

B

Question 12

2 blood vessels that form the portal vein

Answer 12

Splenic v and SMV

Question 13

Where does IMV drain to?

Answer 13

Splenic v

Question 14

Normal pressure inside the portal v.

Answer 14

3-5mmHg

Question 15

The portal vein

a. has valves
b. has no valves

Answer 15

B

Question 16

The portal vein decompress to which vein during portal hpn?

Answer 16

Coronary (L Gastric V)

Question 17

What vein directly cause esophageal and gastric varices?

Answer 17

L gastric V

Question 18

R hepatic vein drains

a. Right anterior segment
b. Segment I
c. Quadrate lobe
d. Segment VI and VII

Answer 18

A. Segments V-VIII

Question 19

Caudate lobe is drained by

a. IMV
b. SMV
c. L hepatic v
d. IVC

Answer 19

D

Question 20

Parasympathetic innervation of the liver is from the

Answer 20

L vagus

Question 21

Sympathetic innervation of the liver

Answer 21

Greater thoracic nerves and celiac ganglia

Question 22

This is a location in the liver between a hepatocyte and a sinusoid.

Answer 22

Presinusoidal space of Disse

Question 23

The space between the stroma of the portal canal and the outermost hepatocytes in the hepatic lobule, and is thought to be one of the sites where lymph originates in the liver.

Answer 23

Periportal clefts of Mall

Question 24

hilar cystic duct LN is also known as

Answer 24

Lund’s node or Mascagni’s lymph node, or erroneously called Calot’s Triangle

Question 25

Enzyome responsible for conjugation of bilirubin

Answer 25

glucoronly transferase

Question 26

Excreted in feces, minimally dissolved in the blood then excreted in urine a. Conjugated bilirubin b. Unconjugated bilirubin

Answer 26

A

Question 27

Rate of bile production by hepatocytes

Answer 27

1L/day

Question 28

components of bile (6)

Answer 28

``` BBLECh Bile pigments Bile salts lecithin Electrolytes Cholesterol ```

Question 29

Functions of bile a. aid in digestion and absorption of lipids and lipid soluble vitamins b. eliminate waste products c. both d. neither

Answer 29

C

Question 30

The mixture of primary and secondary bile salts and bile acids is primarily absorbed in _______

Answer 30

terminal ileum

Question 31

conjugation reactions- glucoronate, acetate, glutathione, glycine, sulfate and methyl group additions – Smooth ER a. PHASE I b. PHASE II

Answer 31

B PHASE I: oxidation, reduction and hydrolysis by Cytochrome P450

Question 32

Predominantly liver specific a. AST b. ALT c. Alk Phos d. LDH

Answer 32

B

Question 33

What tests to evaluate synthetic function of the liver

Answer 33

Albumin and PT

Question 34

The following causes prolonged PT EXCEPT a. Vit K b. Warfarin c. liver cirrhosis d. NOTA

Answer 34

D

Question 35

Impaired bile flow from liver to duodenum either intra or extrahepatic etiology a. cholecystitis b. cholangitis c. cholelithiasis d. cholestasis

Answer 35

D

Question 36

Extrahepatic a. indirect bilirubin elevation b. direct bilirubin elevation

Answer 36

A direct bilirubin elevation = intrahepatic

Question 37

found in liver, bile duct epithelium and bones a. AST b. ALT c. LDH d. ALk Phos

Answer 37

D

Question 38

hepatocytes and biliary epithelium, sensitive to biliary disease if Alk Phos is elevated

Answer 38

GGT

Question 39

Bilirubin levels when jaundice becomes apparent

Answer 39

2.5-3 mg/dL

Question 40

A mild liver disorder in which the liver does not properly process bilirubin. This disease is due to a mutation in the UGT1A1 gene which results in decreased activity of the bilirubin uridine diphosphate glucuronosyltransferase enzyme.

Answer 40

Gilbert's Syndrome

Question 41

This is a rare inherited disorder affecting the metabolism of bilirubin, a chemical formed from the breakdown of the heme in red blood cells. The disorder results in a form of nonhemolytic jaundice, which results in high levels of unconjugated bilirubin and often leads to brain damage in infants.

Answer 41

Crigler-Najar Syndrome

Question 42

defect in transport protein of bilirubin, no pigmentation of liver a. Gilbert's syndrome b. Crigler-Najar Syndrome c. Rotor's Syndrome d. Dubin Johnson Syndrome

Answer 42

C

Question 43

defect in secretion of bilirubin by hepatocytes into the bile a. Gilbert's syndrome b. Crigler-Najar Syndrome c. Rotor's Syndrome d. Dubin Johnson Syndrome

Answer 43

D

Question 44

The following are causes of post hepatic jaundice except a. cholelithiasis b. benign biliary strictures c. pancreatitis d. Rotor's syndrome

Answer 44

D

Question 45

The following are prehepatic EXCEPT a. immune mediated hemolytic anemia, + direct Coomb's test b. malnutrition c. severe burns d. pancreatitis

Answer 45

D. post hepatic

Question 46

Prehepatic cause of jaundice EXCEPT a. malaria b. septicimia c. Carcinoma of the head of pancreas d. Any haemolytic anemia

Answer 46

C - post hepatic

Question 47

Intrahepatic cause of jaundice a. Gilbert's syndrome b. Crigler-Najar syndrome c. Viral hepatitis d. Paracetamol poisoning

Answer 47

AOTA