Hepatology MCQ 90+

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• Drug induced hepatitis occurs in
  ক

  Methyldopa

  খ

  Captopril

  গ

  Zidovudine

  ঘ

  Sodium valproate

  ঙ

  Tetracycline
• Choledocal cyst presents with the following complaints
  ক

  Lump in the right upper quadrant of the abdomen

  খ

  May develop cancer

  গ

  Upper abdominal pain

  ঘ

  Progressive jaundice

  ঙ

  Hepatosplenomegaly
• Autoantibody/ies present in autoimmune hepatitis is/are
  ক

  ANA

  খ

  Anti -LKM

  গ

  Antibodies to soluble liver antigen

  ঘ

  p-ANCA

  ঙ

  c-ANCA
• Contraindication of percutaneous liver biopsy include
  ক

  Non- cooperative patients

  খ

  Prothrombin time> 4 sec

  গ

  Platelet count > lOOx 109/L

  ঘ

  Past history of melaena

  ঙ

  Patients with positive HBsAg
• Wilsons disease
  ক

  Is caused due to mutation of ATP7B gene on chromosome 13

  খ

  May present with features of parkinsonism

  গ

  May be cured by liver transplantation

  ঘ

  Is characterized by increased synthesis of ceruloplasmin

  ঙ

  Is characterized by red colored urine
• Autoimmune liver diseases are
  ক

  Primary sclerosing cholangitis

  খ

  Autoimmune hepatitis

  গ

  Primary biliary cirrhosis

  ঘ

  Progressive systemic sclerosis

  ঙ

  Secondary sclerosing cholangitis
• Hepatorenal syndrome
  ক

  Occurs in advanced cirrhosis

  খ

  May be precipitated by vigorous diuresis

  গ

  Is best treated with liver transplantation

  ঘ

  Urine output is low with high urinary sodium concentration

  ঙ

  Carries an excellent prognosis
• In hepatorenal syndrome
  ক

  Urine output is low

  খ

  May be precipitated by NSAID

  গ

  Liver transplantation is the best option of treatment

  ঘ

  Urinary sodium is high

  ঙ

  Renal histology is abnormal
• Features of hepatorenal syndrome
  ক

  Low serum osmolarity

  খ

  Raised serum creatinine

  গ

  Increased serum uric acid

  ঘ

  High urinary sodium

  ঙ

  Low blood urea nitrogen
• Regarding hepatorenal syndrome
  ক

  Renal failure is functional

  খ

  Kidneys are smaller on imaging

  গ

  It occurs in advanced cirrhosis with ascites

  ঘ

  It may be associated with spontaneous bacterial peritonitis

  ঙ

  It is characterised by significant proteinuria
• Steatosis
  ক

  May lead to cirrhosis

  খ

  May lead to hepatocellular carcinoma

  গ

  May occur in heart

  ঘ

  Is caused by alcohol abuse only

  ঙ

  Is only seen in liver
• Mechanisms of fatty change of the liver are
  ক

  Increased free fatty acid delivery to liver

  খ

  Reversible liver cell injury

  গ

  Increased formation of triglyceride

  ঘ

  Decreased formation of apoprotein

  ঙ

  Liver cell apoptosis
• Acute fatty liver of pregnancy
  ক

  There are biochemical evidences of liver failure

  খ

  Prognosis is excellent

  গ

  Occurs in early pregnancy

  ঘ

  There is macrovascular steatosis in the liver

  ঙ

  Physical findings may be minimal
• Drugs causing fatty liver are
  ক

  Alcohol abuse

  খ

  Tetracycline

  গ

  Valproic acid

  ঘ

  Chlorpromazine

  ঙ

  Nitrofurantion
• Fatty change in liver can lead to
  ক

  Acute hepatitis

  খ

  Cirrhosis of liver

  গ

  Chronic hepatitis

  ঘ

  Hepatic adenoma

  ঙ

  Acute liver failure
• Fatty change of the liver occurs in
  ক

  Starvation

  খ

  Protein energy malnutrition (PE

  গ

  Obesity

  ঘ

  Haemochromatosis

  ঙ

  Wilson’s disease
• Fatty changes in liver occur
  ক

  Starvation

  খ

  Protein energy malnutrition

  গ

  Diabetes mellitus

  ঘ

  Vitamin E deficiency

  ঙ

  Beriberi
• Complications of portal hypertension include
  ক

  Variceal bleeding

  খ

  Hepatic encephalopathy

  গ

  Congestive gastropathy

  ঘ

  Spider angioma

  ঙ

  Testicular atrophy
• Feature/s of portal hypertension is/are
  ক

  Ascites

  খ

  Splenomegaly

  গ

  Variceal bleeding

  ঘ

  Testicuiar atrophy

  ঙ

  Gynaecomastia
• In liver failure there is likely to be
  ক

  Salt & water deprivation

  খ

  Dependent oedema

  গ

  Impaired absorption of fat

  ঘ

  Intoxication after eating a high protein meal

  ঙ

  Raised blood urea
• Biochemical features of fulminating hepatic failure are
  ক

  Low blood urea nitrogen

  খ

  Prolongation of prothrombin time

  গ

  Low serum albumin

  ঘ

  Metabolic alkalosis

  ঙ

  Low blood ammonia level
• A cirrhosis case is likely to due to alpha 1 antitrypsin deficiency if
  ক

  The patient is pizz genotype

  খ

  If the patient shows typical clinical features at onset

  গ

  His/her liver biopsy shows alpha 1 antitrypsin globules

  ঘ

  His/her plasma alpha 1 antitrypsin is low

  ঙ

  He/she has early onset has severe disease
• Fulminant hepatitis is caused by
  ক

  Hepatitis A

  খ

  Hepatitis B

  গ

  Wilson disease

  ঘ

  Phenytoin

  ঙ

  Galactosaemia
• The following biochemical disturbances occur in fulminating hepatic failure
  ক

  Metabolic acidosis

  খ

  Hyperkalaemiaia

  গ

  Hypoglycaemia

  ঘ

  Fall in Po2

  ঙ

  Hypernatraemia
• Fulminant hepatic failure is characterized by
  ক

  Hepatic encephalopathy

  খ

  INR>3

  গ

  Coagulopathy

  ঘ

  Absence of hemorrhage

  ঙ

  Its occurrence usually 6 months after the onset of acute liver disease
• In cirrhosis of liver encephalopathy may be precipitated by
  ক

  Hypokalemia

  খ

  High protein diet

  গ

  Paracentesis

  ঘ

  Injection of vitamin K

  ঙ

  High carbohydrate diet
• Cirrhosis of liver is caused by the followings
  ক

  Hepatitis C virus

  খ

  Hepatitis B virus

  গ

  Hepatitis A virus

  ঘ

  Cytomegalovirus

  ঙ

  Epstein Barr virus
• In hepatic failure the following biochemical abnormalities may be found
  ক

  Increased plasma globulin

  খ

  Increased the blood ammonia concentration

  গ

  Impaired glucose tolerance

  ঘ

  Increased plasma albumin concentration

  ঙ

  Increased the blood urea
• Causes of chronic liver disease are
  ক

  Hepatitis D virus infection

  খ

  Hepatitis C virus infection

  গ

  Alpha 1 antitrypsin deficiency

  ঘ

  Hepatitis E virus infection

  ঙ

  Hepatitis A virus infection
• Following drugs are contraindicated in decompensated cirrhosis of liver
  ক

  Oral hypoglycemic agents

  খ

  Pegylated interferon

  গ

  Antihypertensives

  ঘ

  Propranolol

  ঙ

  Tenofovir