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</p> Signup and view all the answers

    What is a common cause of liver disease?

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

    What is a metabolic cause of liver disease?

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

    What is the average incubation period for hepatitis B?

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

    What percentage of people with hepatitis C are asymptomatic?

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

    How is hepatitis prevented?

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

    What type of virus is hepatitis C?

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

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

    <p>15-30%</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.</p> Signup and view all the answers

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

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

    What is the primary cause of jaundice?

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

    What is the main risk of obstructive jaundice in surgery?

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

    What is the primary dental complication of jaundice?

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

    What is the primary symptom of liver failure?

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

    What is the primary cause of cirrhosis?

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

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

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

    What is the primary investigation used to diagnose liver disease?

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

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

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

    What is the primary risk factor for gallstones?

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

    What is the primary treatment for gallstones?

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

    What type of infection precedes the development of rheumatic fever?

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

    Which heart valve is most commonly affected by rheumatic fever?

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

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

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

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

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

    What is a risk factor for developing rheumatic fever?

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

    What is a complication of rheumatic fever in the heart?

    <p>Pancarditis</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</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</p> Signup and view all the answers

    What is hematuria a sign of?

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

    What is one of the possible causes of hematuria?

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

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

    <p>Hematuria</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</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</p> Signup and view all the answers

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

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

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

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

    What is the primary risk factor for developing endocarditis?

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

    What is the primary consequence of endocarditis?

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

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

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

    What percentage of endocarditis patients have negative blood cultures?

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

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

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

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

    <p>Streptococci</p> Signup and view all the answers

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

    <p>Splenomegaly</p> Signup and view all the answers

    What is the purpose of blood culture assessment in endocarditis?

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

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

    <p>Embolism</p> Signup and view all the answers

    What is the purpose of echocardiogram in endocarditis?

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

    What is the typical duration of antibiotic therapy for endocarditis?

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

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

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

    What is a risk factor for infective endocarditis?

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

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

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

    What is a possible consequence of compromising cardiovascular system?

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

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

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

    What is the primary treatment for hypertension?

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

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

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

    What is a common dental side effect of corticosteroids?

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

    What is a potential dental problem for patients with epilepsy?

    <p>Convulsions</p> Signup and view all the answers

    What is one of the functions of the liver?

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

    What is the most commonly used long-term anticoagulant?

    <p>Warfarin</p> Signup and view all the answers

    What is a potential consequence of alcohol dependence?

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

    What must be avoided in patients with liver disease?

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

    What does the INR measure?

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

    What is the purpose of corticosteroids?

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

    What is a potential side effect of using corticosteroids?

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

    What should be avoided in patients with a bleeding risk?

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

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

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

    What is the process of artificially depressing the immune system?

    <p>Immunosuppression</p> Signup and view all the answers

    Which of the following is a feature of innate immunity?

    <p>Immediate</p> Signup and view all the answers

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

    <p>Immunocompromised</p> Signup and view all the answers

    What is the first step of innate immunity?

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

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

    <p>HIV infection</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.</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.</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.</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.</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.</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.</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</p> Signup and view all the answers

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

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

    What is the primary means of genetic exchange in conjugation?

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

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

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

    How do beta-lactam antibiotics combat beta-lactamases?

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

    What is the resistome?

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

    What is an advantage of using bacteriophages as antibiotics?

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

    What is a mechanism of drug resistance in fungi?

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

    What is a way to combat drug resistance?

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

    What is the lytic cycle of bacteriophages?

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

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

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

    How do aminoglycosides work against bacterial infections?

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

    What is the mechanism of trimethoprim resistance in bacteria?

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

    How do quinolones work against bacterial infections?

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

    What is the mechanism of quinolone resistance in bacteria?

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

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

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

    What are the two main cell lines that leukaemias take?

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

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

    <p>Allogenic</p> Signup and view all the answers

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

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

    What is a complication of Allogenic HSCT?

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

    What is a clinical feature of GvHD?

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

    What is a known risk factor for developing leukaemia?

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

    How is xerostomia managed in patients with GvHD?

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

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

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

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

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

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

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

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

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

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

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

    What is the most common leukaemia in adults?

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

    What is the primary investigation used to diagnose multiple myeloma?

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

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

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

    What is the primary oral complication of multiple myeloma?

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

    What is the primary management approach for intraoral lymphomas?

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

    What is the primary dental symptom of leukaemia?

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

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

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

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

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

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

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

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