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Question 1

Which of the following is correct regarding liver function tests?

a) Liver function tests are always deranged in patients with significant liver disease.

b) An isolated rise in alkaline phosphatase level implies biliary disease.

c) An isolated rise in b-glutamyltransferase (GGT) is often seen in alcoholics.

d) Mild elevations of bilirubin, alanine aminotransferase, and aspartate aminotransferase are typical of Gilbert's syndrome.

Question 2

Which of the following is correct regarding hepatic failure?

a) The cardinal features are hepatic encephalopathy, coagulopathy, and jaundice.

b) Most cases following a sudden massive insult to a previous healthy liver.

c) The activated partial thromoplastin time (APTT) serves as a good indicator of the severity of hepatic failure.

d) Prognosis is generally good for recovery.

Question 3

Which of the following is correct regarding hepatitis B infection?

a) Acute infection usually causes a clinically evident episode of acute icteric hepatitis.

b) Most patients develop chronic infection.

c) The presence of serum anti-hepatitis B surface antigen antibodies implies infection with the virus.

d) The viral X protein is believed to be important in the pathogenesis of hepatitis B related hepatocellular carcinoma.

Question 4

Which of the following is correct regarding hepatitis C infection?

a) Most cases are sexually transmitted.

b) Acute infection usually causes a clinically evident episode of acute icteric hepatitis.

c) Most patients develop chronic infection.

d) The precise genotype of the virus does not affect response to treatment.

Question 5

Which of the following is correct regarding alcoholic liver disease?

a) Alcoholic fatty liver is irreversible.

b) Alcoholic hepatitis is defined by the presence of inflammation in the liver.

c) Severe alcoholic hepatitis may lead to acute hepatic failure.

d) Alcohol is the second most common cause of chronic liver disease.

Question 6

Which of the following is correct regarding non-alcoholic liver disease?

a) Most patients with non-alcoholic fatty liver disease present with persistent right upper quadrant discomfort.

b) Non-alcoholic steatohepatitis is thought to account for many cases of cirrhosis previously labelled as "cryptogenic".

c) Alcoholic and non-alcoholic liver disease can be distinguished on a liver biopsy.

d) The incidence of non-alcoholic liver disease is falling.

Question 7

Which of the following is correct regarding cirrhosis?

a) It is defined by the presence of fibrosis in the liver.

b) The key cell implicated in the laying down of fibrosis is the activated Kupffer cell.

c) Ascites occurs early after the onset of cirrhosis.

d) Most patients die of decompensated hepatic failure.

Question 8

Which of the following is correct regarding gallstones?

a) Most people with gallstones are symptomatic.

b) Biliary colic is a systemic disease characterized due to inflammation in the gallbladder wall set up by an impacted gallstone.

c) Chronic cholecystitis refers to symptoms of dyspepsia in patients with gallstones.

d) Gallstones are a common cause of obstructive jaundice.

Question 9

Which of the following is correct regarding acute pancreatitis?

a) The typical presentation is acute upper abdominal pain with features of localized peritonitis.

b) The most common causes are alcohol and blunt trauma to the pancreas.

c) Infection of a necrotic pancreas is an ominous development.

d) It increases the risk of future development of pancreatic carcinoma.

Question 10

Which of the following is correct regarding pancreatic carcinoma?

a) Most arise in the body of the pancreas.

b) Severe weight loss is a common feature.

c) Most are squamous cell carcinomas.

d) Most patients have a potentially resectable tumour at presentation.

Oxford University Press, Online Resource Centre, Chapter 09.

Chapter 09

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