Weekly Check Point - Liver and Pancreatic Disease

Question 1

The liver plays a key role in detoxification by converting ammonia into which substances?

A. Bile salts

B. Bilirubin

C. Urea

D. Uric acid

Answer 1

C. Urea

Question 2

Which clotting factor is exclusively produced by the liver?

A. Factor VIll

B. Factor VIl

C. Factor III (Tissue factor)

D. von Willebrand factor

Answer 2

B. Factor VIl

Question 3

Which enzyme is most specific for liver injury?

A. Gamma-glutamyl transferase (GGT)

B. Alanine aminotransferase (ALT)

C. Aspartate aminotransferase (AST)

D. Alkaline phosphatase (ALP)

Answer 3

B. Alanine aminotransferase (ALT)

Question 4

Which findings suggest a positive asterixis sign during physical examination?

A. A fine resting tremor of the hands that disappears with movement

B. A sudden loss of postural tone in the hands, causing a “flapping” motion when wrists are extended

C. A sustained contraction of the hands when squeezing an examiner’s fingers

D. A rapid, rhythmic shaking of the hands when arms are extended

Answer 4

B. A sudden loss of postural tone in the hands, causing a “flapping” motion when wrists are extended

Question 5

A 39-year old patient presents with severe epigastric pain radiating to the back, nause
What is the most appropriate next step in management?

A. Colonoscopy

B. Immediate ERCP

C. Liver biopsy

D. IV fluids and pain control

Answer 5

D. IV fluids and pain control

Question 6

Which one of the following is a common cause of post-hepatic jaundice?

A. Wilson’s disease

B. Alcoholic hepatitis

C. Pancreatic cancer

D. Autoimmune hepatitis

Answer 6

C. Pancreatic cancer

Question 7

A 52 year-old patient presents with severe epigastric pain, jaundice, and fever. His total bilirubin is 7 mg/dL, and ALP is significantly elevated.
What is the most likely diagnosis?

A. Viral hepatitis

B. Chronic pancreatitis

C. Acute pancreatitis

D. Acute cholangitis

Answer 7

D. Acute cholangitis

Question 8

A 60 year-old patient presents with jaundice, pruritus, and dark urine.
Which one of the following best differentiates obstructive jaundice from hepatic jaundice?

A. Decreased urinary urobilinogen

B. Normal alkaline phosphatase

C. Elevated unconjugated bilirubin

D. Presence of coniugated bilirubin in urine

Answer 8

D. Presence of coniugated bilirubin in urine

Question 9

Which one of the following best describes bilirubin metabolism?

A. Conjugated bilirubin is converted into urobilinogen in the spleen

B. Unconjugated bilirubin is water-soluble

C. Bilirubin is conjugated in hepatocytes by UDP-glucuronosyltransferase

D. Conjugation of bilirubin occurs in the kidney

Answer 9

C. Bilirubin is conjugated in hepatocytes by UDP-glucuronosyltransferase

Question 10

Which one of the following is NOT a function of the liver?

A. Glycogen storage

B. Urea production

C. Erythropoietin production

D. Cholesterol synthesis

Answer 10

C. Erythropoietin production