Anatomy and Functions of the Liver
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Questions and Answers

In which region of the body is the liver located?

  • Epigastric region
  • Right hypochondrium (correct)
  • Left hypochondrium
  • Umbilical region

How many lobes is the liver divided into?

  • 6
  • 4 (correct)
  • 3
  • 5

What is the main function of the hepatic artery?

  • To produce bile
  • To drain the liver of deoxygenated blood
  • To supply the liver with oxygenated blood (correct)
  • To store glycogen

Which of the following is a function of the liver?

<p>Production of albumin (C)</p> Signup and view all the answers

What is a common cause of liver disease?

<p>Viral hepatitis (B)</p> Signup and view all the answers

What is a metabolic cause of liver disease?

<p>Non-alcoholic fatty liver disease (D)</p> Signup and view all the answers

What is the average incubation period for hepatitis B?

<p>75 days (A)</p> Signup and view all the answers

What percentage of people with hepatitis C are asymptomatic?

<p>80% (D)</p> Signup and view all the answers

How is hepatitis prevented?

<p>95% effective vaccine with 3 doses (C)</p> Signup and view all the answers

What type of virus is hepatitis C?

<p>Hepacivirus of Flaviviridae family (A)</p> Signup and view all the answers

What percentage of people with hepatitis C will develop liver cirrhosis within 20 years?

<p>15-30% (A)</p> Signup and view all the answers

What is the primary difference between acute and chronic liver disease?

<p>Acute liver disease is when the liver is coping with reduced capacity, while chronic liver disease is when the liver is failing to cope. (B)</p> Signup and view all the answers

Dentally, what method of anaesthesia is recommended for people with liver disease?

<p>Local anaesthesia (A)</p> Signup and view all the answers

What is the primary cause of jaundice?

<p>Buildup of bilirubin in the blood and body tissues. (A)</p> Signup and view all the answers

What is the risk of transmission percentage for hepatitis B from a patient to a healthcare worker with a needlestick injury?

<p>Up to 30% (D)</p> Signup and view all the answers

What is the primary way bilirubin is normally reduced in the blood?

<p>Through the secretion of bilirubin into the small intestine via the bile duct. (D)</p> Signup and view all the answers

What is the main risk of obstructive jaundice in surgery?

<p>Bleeding due to vitamin K malabsorption (B)</p> Signup and view all the answers

What is the primary dental complication of jaundice?

<p>Dental hypoplasia. (C)</p> Signup and view all the answers

What is dental hypoplasia and a greenish discoloration of the teeth in liver disorders associated with?

<p>Rhesus disease (A)</p> Signup and view all the answers

What is the primary symptom of liver failure?

<p>All of the above. (D)</p> Signup and view all the answers

What is the primary cause of cirrhosis?

<p>All of the above. (D)</p> Signup and view all the answers

What are 2 risk factors for non-alcoholic fatty liver disease?

<p>Type II diabetes and HBP (A)</p> Signup and view all the answers

What is the primary investigation used to diagnose liver disease?

<p>All of the above. (D)</p> Signup and view all the answers

What is the primary complication of non-alcoholic fatty liver disease?

<p>Cirrhosis. (B)</p> Signup and view all the answers

What is the primary risk factor for gallstones?

<p>All of the above. (D)</p> Signup and view all the answers

What is the primary treatment for gallstones?

<p>Laparoscopic cholecystectomy. (D)</p> Signup and view all the answers

What type of infection precedes the development of rheumatic fever?

<p>Group A streptococcal infection (B)</p> Signup and view all the answers

Which heart valve is most commonly affected by rheumatic fever?

<p>Mitral valve (A)</p> Signup and view all the answers

What is the typical age range for the onset of rheumatic fever?

<p>5-15 years (D)</p> Signup and view all the answers

What is the duration of the latent period before rheumatic fever sets in?

<p>2-6 weeks (C)</p> Signup and view all the answers

What is a risk factor for developing rheumatic fever?

<p>HLA DR4 positive (B)</p> Signup and view all the answers

What is a complication of rheumatic fever in the heart?

<p>Pancarditis (A)</p> Signup and view all the answers

What type of patients are at risk of developing infective endocarditis?

<p>Adults and children with structural cardiac defects (A)</p> Signup and view all the answers

How can a dentist aid in the prevention of infective endocarditis?

<p>By removing caries that contain streptococci viridians on a regular basis (D)</p> Signup and view all the answers

What is hematuria a sign of?

<p>Kidney stone or tumor in the urinary tract (B)</p> Signup and view all the answers

What does the presence of white blood cells in the urine, along with red blood cells, indicate?

<p>Urinary tract infection (A)</p> Signup and view all the answers

What is one of the possible causes of hematuria?

<p>All of the above (D)</p> Signup and view all the answers

What is a possible complication of prolonged exercise or horseback/bicycle riding?

<p>Hematuria (A)</p> Signup and view all the answers

What is the primary diagnostic criterion for rheumatic fever?

<p>The presence of 2 major and 1 minor criteria (B)</p> Signup and view all the answers

What is the most common joint involvement in polyarthritis associated with rheumatic fever?

<p>Large joints of the legs and arms (A)</p> Signup and view all the answers

What is the percentage of patients with rheumatic fever who develop carditis?

<p>40-50% (A)</p> Signup and view all the answers

What is the characteristic of the rash seen in erythema marginatum?

<p>It is a round, pale-pink center, surrounded by a slightly raised red outline (A)</p> Signup and view all the answers

What is the association between subcutaneous nodules and rheumatic fever?

<p>They occur 4-6 weeks after rheumatic fever (A)</p> Signup and view all the answers

What is the percentage of patients with rheumatic fever who develop chorea?

<p>10-20% (C)</p> Signup and view all the answers

What is the primary reason for the increasing incidence of endocarditis?

<p>Increasing number of elderly people with abnormal/prosthetic valves (A)</p> Signup and view all the answers

What is the primary mechanism of endocarditis?

<p>Infection of the endocardial surface of the heart or valves (A)</p> Signup and view all the answers

What is the primary risk factor for developing endocarditis?

<p>Abnormal cardiac endothelium (B)</p> Signup and view all the answers

What is the primary consequence of endocarditis?

<p>Valvular damage (D)</p> Signup and view all the answers

What allows organisms to adhere and grow, leading to characteristic infections?

<p>Small thrombi (D)</p> Signup and view all the answers

What percentage of endocarditis patients have negative blood cultures?

<p>5-10% (B)</p> Signup and view all the answers

What is a common feature of endocarditis in patients over 65?

<p>Minor degenerative lesions (B)</p> Signup and view all the answers

What is the most common organism involved in the pathogenesis of endocarditis?

<p>Streptococci (D)</p> Signup and view all the answers

What is a characteristic clinical feature of late-stage endocarditis?

<p>Splenomegaly (C)</p> Signup and view all the answers

What is the purpose of blood culture assessment in endocarditis?

<p>To guide future antibiotic therapy (D)</p> Signup and view all the answers

What is a complication of endocarditis that can lead to stroke?

<p>Embolism (C)</p> Signup and view all the answers

What is the purpose of echocardiogram in endocarditis?

<p>To identify the presence of vegetations or abscesses (D)</p> Signup and view all the answers

What is the typical duration of antibiotic therapy for endocarditis?

<p>4-6 weeks (D)</p> Signup and view all the answers

What is a condition that may require surgical intervention in endocarditis?

<p>Extensive damage to a valve (C)</p> Signup and view all the answers

What is a medically compromised patient?

<p>A patient with a condition or treatment of the condition that may impact on the delivery of safe and optimal dental care (B)</p> Signup and view all the answers

What is the primary purpose of taking a thorough medical history?

<p>To understand the significance of the disease and how it affects dental care (D)</p> Signup and view all the answers

What is a risk factor for infective endocarditis?

<p>All of the above (D)</p> Signup and view all the answers

What is the preferred anaesthetic for patients with a compromised cardiovascular system?

<p>Citanest without adrenaline (B)</p> Signup and view all the answers

What is a possible consequence of compromising cardiovascular system?

<p>All of the above (D)</p> Signup and view all the answers

What is no longer routinely recommended for patients with infective endocarditis?

<p>Antibiotic prophylaxis (A)</p> Signup and view all the answers

What is the primary treatment for hypertension?

<p>Antihypertensive drugs (D)</p> Signup and view all the answers

What is a potential problem with patients who have respiratory disease?

<p>Inhaled steroid and oral candida (D)</p> Signup and view all the answers

What dose of corticosteroid should a patient take if they are having surgery, and have been taking corticosteroids for over 3 weeks at more than 30mg a day?

<p>Double their normal dose (D)</p> Signup and view all the answers

What must be considered when scheduling appointments for patients with diabetes?

<p>Timing of appointments to avoid hypoglycaemia (C)</p> Signup and view all the answers

What is a common dental side effect of corticosteroids?

<p>Oral candidiasis (A)</p> Signup and view all the answers

What is a potential dental problem for patients with epilepsy?

<p>Convulsions (B)</p> Signup and view all the answers

What is one of the functions of the liver?

<p>Excreting bile for fat digestion (D)</p> Signup and view all the answers

What should be avoided in patients taking corticosteroids and why?

<p>NSAIDs, because they increase the risk of peptic ulceration (C)</p> Signup and view all the answers

What is the most commonly used long-term anticoagulant?

<p>Warfarin (C)</p> Signup and view all the answers

What is a potential consequence of alcohol dependence?

<p>Liver disease (D)</p> Signup and view all the answers

What must be avoided in patients with liver disease?

<p>NSAIDs and metronidazole (D)</p> Signup and view all the answers

What does the INR measure?

<p>The time for the blood to clot using prothrombin proteins (A)</p> Signup and view all the answers

What is the purpose of corticosteroids?

<p>To reduce inflammation and suppress the immune system (B)</p> Signup and view all the answers

What should the INR levels be if a patient is taking warfarin to treat DVT or PE?

<p>3.5-4.5 (D)</p> Signup and view all the answers

What is a potential side effect of using corticosteroids?

<p>Cushings syndrome (A)</p> Signup and view all the answers

When should a dental appointment be booked for a patient with a bleeding risk?

<p>Early in the day (D)</p> Signup and view all the answers

What is the purpose of taking a history of a patient with a bleeding risk?

<p>To identify potential bleeding risks (A)</p> Signup and view all the answers

What must be considered when taking patients with corticosteroids off the medication?

<p>If the patient has been taking the medication for over 3 weeks and more than 30mg a day (C)</p> Signup and view all the answers

What should be avoided in patients with a bleeding risk?

<p>All of the above (C)</p> Signup and view all the answers

What can the use of antibiotics do to the potency of warfarin?

<p>Potentiate it (B)</p> Signup and view all the answers

What is the term for a state where the immune system is below the optimum level?

<p>Immunodeficient (D)</p> Signup and view all the answers

What is the process of artificially depressing the immune system?

<p>Immunosuppression (C)</p> Signup and view all the answers

Which of the following is a feature of innate immunity?

<p>Immediate (C)</p> Signup and view all the answers

What is the term for individuals who are at risk due to reduced immune function?

<p>Immunocompromised (C)</p> Signup and view all the answers

What is the first step of innate immunity?

<p>Recognition of pathogens (B)</p> Signup and view all the answers

Which of the following is an example of an acquired immunodeficiency?

<p>HIV infection (C)</p> Signup and view all the answers

What is the primary difference between intrinsic and acquired resistance?

<p>Intrinsic resistance is inherent, whereas acquired resistance is developed through mutation and natural selection. (C)</p> Signup and view all the answers

What is the primary way that microbes can acquire resistance through horizontal evolution?

<p>Through the transfer of genes or genetic material between microbes. (C)</p> Signup and view all the answers

What is the primary function of transposons in acquired resistance?

<p>To copy and move genes within a genome or between genomes. (D)</p> Signup and view all the answers

What is the primary way that microbes can acquire resistance through vertical evolution?

<p>Through spontaneous mutations and natural selection. (D)</p> Signup and view all the answers

What is the primary characteristic of intrinsic resistance?

<p>It affects almost all species strains and existed before antibiotic use. (D)</p> Signup and view all the answers

What is the primary way that genes can duplicate to cause resistance in a strain?

<p>Through homologous recombination. (D)</p> Signup and view all the answers

What is the purpose of the minimum inhibitory concentration (MIC) test?

<p>To determine the smallest concentration of antibiotic that inhibits the growth of an organism (B)</p> Signup and view all the answers

Which of the following mechanisms of resistance involves the breakdown of antibiotics by enzymes?

<p>Enzymatic degradation (D)</p> Signup and view all the answers

What is the primary means of genetic exchange in conjugation?

<p>Sexual pilus (A)</p> Signup and view all the answers

Which of the following bacteria can genetically exchange their antimicrobial resistant genes?

<p>Enterobacteriaceae and Pneumococci (C)</p> Signup and view all the answers

What is the term for the process by which bacteria take up short fragments of naked DNA?

<p>Transformation (D)</p> Signup and view all the answers

What is the primary difference between the MIC tests in liquid media and solid media?

<p>The method of measuring antibiotic susceptibility (B)</p> Signup and view all the answers

What is the mechanism of resistance by which microbes prevent antibiotics from entering the cell?

<p>Antimicrobial exclusion (D)</p> Signup and view all the answers

Which of the following is an example of a beta-lactamase?

<p>An enzyme that breaks down beta-lactam antibiotics (C)</p> Signup and view all the answers

What is the primary difference between beta-lactamases in gram-negative and gram-positive bacteria?

<p>The location of the enzyme (C)</p> Signup and view all the answers

How do beta-lactam antibiotics combat beta-lactamases?

<p>By modifying the antibiotic structure (C)</p> Signup and view all the answers

What is an example of a drug that can be a victim to enhanced target production?

<p>Trimethoprim (B)</p> Signup and view all the answers

What is the function of efflux pumps in antibiotic resistance?

<p>To pump antibiotics out of the cell (D)</p> Signup and view all the answers

What is the resistome?

<p>A collection of antibiotic-resistant genes (D)</p> Signup and view all the answers

What is an advantage of using bacteriophages as antibiotics?

<p>They are specific to individual bacterial species (D)</p> Signup and view all the answers

What is the lysogenic cycle of bacteriophages?

<p>The cycle where the phage genome integrates into the bacterial chromosome (D)</p> Signup and view all the answers

What is a limitation of using bacteriophages as antibiotics?

<p>They require specific identification of the infecting bacteria (C)</p> Signup and view all the answers

What is an example of an antifungal drug that can be affected by drug resistance mechanisms?

<p>Fluconazole (A)</p> Signup and view all the answers

What is a mechanism of drug resistance in fungi?

<p>All of the above (D)</p> Signup and view all the answers

What is a way to combat drug resistance?

<p>Using the correct antibiotic (C)</p> Signup and view all the answers

What is the mechanism by which clavulanic acid inhibits beta-lactamases?

<p>By causing irreversible acylation of beta-lactamases (C)</p> Signup and view all the answers

What is the lytic cycle of bacteriophages?

<p>The cycle where the phage lyses the bacterial cell (B)</p> Signup and view all the answers

How do glycopeptides inhibit bacterial cell wall synthesis?

<p>By binding to the amino acids in the peptidoglycan (B)</p> Signup and view all the answers

What is the mechanism of resistance to glycopeptides in some bacteria?

<p>Modification of the peptidoglycan precursor (D)</p> Signup and view all the answers

How do aminoglycosides work against bacterial infections?

<p>By inhibiting protein synthesis (C)</p> Signup and view all the answers

What is the mechanism of trimethoprim resistance in bacteria?

<p>Modification of the dihydrofolate reductase enzyme (C)</p> Signup and view all the answers

What is drug target bypass in the context of antibiotic resistance?

<p>A mechanism by which bacteria side-step the target of the antibiotic (D)</p> Signup and view all the answers

How do quinolones work against bacterial infections?

<p>By inhibiting DNA replication (C)</p> Signup and view all the answers

What is the mechanism of quinolone resistance in bacteria?

<p>Modification of the topoisomerase IV enzyme (A)</p> Signup and view all the answers

How do chloramphenicol acetyl transferases contribute to antibiotic resistance?

<p>By acetylating chloramphenicol, making it unable to bind to the ribosome (B)</p> Signup and view all the answers

What is the mechanism of enhanced target production in antibiotic resistance?

<p>Bacteria increase the production of the target enzyme (B)</p> Signup and view all the answers

What is the primary cause of anaemia, neutropenia, and thrombocytopenia in leukaemia?

<p>Bone marrow failure (B)</p> Signup and view all the answers

What is the recommended oral care advice following radiotherapy?

<p>Reinforcement of oral hygiene and preventative dental care (A)</p> Signup and view all the answers

What are the two main cell lines that leukaemias take?

<p>Lymphoid and Myeloid (A)</p> Signup and view all the answers

What is the type of HSCT that uses cells from another human that match?

<p>Allogenic (A)</p> Signup and view all the answers

What is the classification of leukaemia based on the maturity of cells?

<p>Acute and Chronic (B)</p> Signup and view all the answers

What is the purpose of analysing blood film and bone marrow in the diagnosis of leukaemia?

<p>All of the above (D)</p> Signup and view all the answers

What is a complication of Allogenic HSCT?

<p>Graft vs host disease (A)</p> Signup and view all the answers

What is a clinical feature of GvHD?

<p>Lichenoid inflammation on the tongue and buccal mucose (A)</p> Signup and view all the answers

What is a known risk factor for developing leukaemia?

<p>All of the above (D)</p> Signup and view all the answers

What is the effect of leukaemic cells on the immune system?

<p>It impairs the immune function, making the individual more susceptible to infections (C)</p> Signup and view all the answers

How is xerostomia managed in patients with GvHD?

<p>With pilocarpine or cevimeline to stimulate saliva production (D)</p> Signup and view all the answers

What is the prognosis for Non-Hodgkin's lymphoma relative to?

<p>Stage of disease (D)</p> Signup and view all the answers

What percentage of patients with Non-Hodgkin's lymphoma experience complete remission?

<p>60-90% (C)</p> Signup and view all the answers

What is the typical age range for the peak incidence of Non-Hodgkin's lymphoma?

<p>40-60 (A)</p> Signup and view all the answers

What is the aetiology of Non-Hodgkin's lymphoma?

<p>Immunodeficiency, infections, and ionising radiation (B)</p> Signup and view all the answers

What is the primary cause of tissue infiltration in leukaemia?

<p>Neoplastic cells spill out of the bone marrow into blood (D)</p> Signup and view all the answers

What is the primary treatment approach for low-grade Non-Hodgkin's lymphoma?

<p>Intermittent oral chemotherapy (C)</p> Signup and view all the answers

What is the characteristic of multiple myeloma that leads to bone destruction?

<p>Stimulation of osteoclasts (D)</p> Signup and view all the answers

What is the most common leukaemia in adults?

<p>Acute Myeloid Leukaemia (AML) (A)</p> Signup and view all the answers

What is the peak incidence age for Acute Lymphoblastic Leukaemia (ALL)?

<p>Children that are 4-5 years old (D)</p> Signup and view all the answers

What is the typical asymptomatic phase of multiple myeloma known as?

<p>Monoclonal gammopathy of undetermined significance (MGUS) (A)</p> Signup and view all the answers

What is the primary investigation used to diagnose multiple myeloma?

<p>Protein electrophoresis (A)</p> Signup and view all the answers

What is the treatment for Acute Lymphoblastic Leukaemia (ALL)?

<p>Remission induced with non-myelosuppressive chemotherapy (D)</p> Signup and view all the answers

What is the characteristic of the Philadelphia chromosome in Chronic Myeloid Leukaemia (CML)?

<p>A balanced translocation between chromosome 9 and 22 (B)</p> Signup and view all the answers

What is the primary oral complication of multiple myeloma?

<p>Leukaemic infiltration (B)</p> Signup and view all the answers

What is the primary management approach for intraoral lymphomas?

<p>Combination therapy (B)</p> Signup and view all the answers

What is the primary dental symptom of leukaemia?

<p>Gingival hypertrophy (D)</p> Signup and view all the answers

What is the peak incidence age for Chronic Lymphoblastic Leukaemia (CLL)?

<p>The elderly (over 60s) (D)</p> Signup and view all the answers

What is the primary treatment for Chronic Lymphoblastic Leukaemia (CLL)?

<p>Chemotherapy typically effective (D)</p> Signup and view all the answers

What is the median age for the onset of Chronic Myeloid Leukaemia (CML)?

<p>40-50 years old (A)</p> Signup and view all the answers

What is the primary clinical feature of Hodgkin's disease?

<p>Painless, non-tender, rubbery lymphadenopathy (D)</p> Signup and view all the answers

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