Module 2_Unit 2 (Part 3)
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Questions and Answers

What does abnormal results in the BSP test may indicate?

  • Increased synthesis of lipids
  • Excessive bile acid production
  • Defective hepatic blood flow and biliary obstruction (correct)
  • Normal liver function

    • How is the normal liver function determined in the BSP test?

  • Excretion of 5% or more of the injected dye after 45 minutes (correct)
  • Rapid metabolism of the injected dye within 30 minutes
  • No detectable dye remaining in the liver after 45 minutes
  • Presence of 0.4 mg or less dye per 100 ml 45 minutes after injection

    • Which of the following substances is NOT metabolized in the liver?

  • Lipids
  • Ammonia
  • Insulin (correct)
  • Bilirubin

    • What diagnostic tests can be used to assess cirrhosis?

    <p>Prothrombin time and partial thromboplastin time</p> Signup and view all the answers

    Which of the following is a possible consequence of impaired metabolic liver function?

    <p>Decreased serum albumin levels</p> Signup and view all the answers

    What do abnormal results in the BSP test suggest?

    <p>Impaired hepatic blood flow and biliary obstruction</p> Signup and view all the answers

    Which condition is characterized by diffuse fibrosis with nodular regeneration in the liver?

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

    Which type of bilirubin is increased in Gilbert's syndrome?

    <p>Unconjugated bilirubin</p> Signup and view all the answers

    Which condition is associated with a rise in prothrombin time and a decrease in platelet count?

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

    Which liver function test ratio is typically elevated in cirrhosis?

    <p>AST/ALT ratio &gt;1</p> Signup and view all the answers

    Which condition presents with intense itching, swelling in legs & abdomen, and bleeding from the GI tract?

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

    What is the primary symptom of Dubin-Johnson syndrome?

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

    'End stage of scar formation and regeneration in chronic liver injury' describes which liver condition?

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

    What is the main characteristic of chronic hepatitis?

    <p>Elevated cytosolic enzymes</p> Signup and view all the answers

    Which virus is NOT typically associated with causing hepatic viral infection?

    <p>Hepatitis B virus</p> Signup and view all the answers

    What is a major predisposing factor for cirrhosis and hepatocellular carcinoma?

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

    In non-alcoholic steatohepatitis, fatty liver disease results from:

    <p>Insulin resistance</p> Signup and view all the answers

    Which factor is NOT associated with the development of non-alcoholic steatohepatitis?

    <p>Wilson’s disease</p> Signup and view all the answers

    What distinguishes acute hepatitis from chronic hepatitis?

    <p>Inflammation persists for ≥6 months</p> Signup and view all the answers

    Which component is NOT a major component of chronic hepatitis?

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

    In viral hepatitis, what enzymes show marked elevations, often 8-50 times the upper limit?

    <p>ALT/AST</p> Signup and view all the answers

    Which type of hepatitis may show a transient increase in lactate dehydrogenase?

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

    What is a characteristic of drug-induced hepatitis in terms of ALT and AST activities?

    <p>Gradual rise in aminotransferases</p> Signup and view all the answers

    Which enzyme may be increased in some cases of acute hepatitis in addition to GGT?

    <p>Alkaline phosphatase</p> Signup and view all the answers

    What type of hepatitis is identified by various viruses including CMV and EBV?

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

    Which form of drug-induced hepatitis is characterized by an increase in ALP?

    <p>Cholestatic form</p> Signup and view all the answers

    What enzyme typically peaks before the peak of bilirubin in viral hepatitis?

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

    What is the structure of Alpha-fetoprotein (AFP) similar to?

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

    Which liver disease is commonly associated with Anti-Mitochondrial Antibody detection?

    <p>Primary Biliary Cirrhosis</p> Signup and view all the answers

    What is the main diagnostic importance of Alpha-fetoprotein (AFP) in liver health screenings?

    <p>Screening for Hepatocellular Carcinoma (HCC)</p> Signup and view all the answers

    Which enzyme has the longest half-life among the ones listed?

    <p>Mitochondrial AST</p> Signup and view all the answers

    Which test is NOT commonly used for detecting liver autoimmune diseases?

    <p>ALP test</p> Signup and view all the answers

    What is the role of Anti-Mitochondrial Antibodies in autoimmune liver diseases?

    <p>Destroying intrahepatic ducts</p> Signup and view all the answers

    Which liver disease is characterized by destruction of both intra and extrahepatic bile ducts?

    <p>Primary Sclerosing Cholangitis</p> Signup and view all the answers

    What is a common symptom associated with Ischemic Hepatitis?

    <p>'Mid zone' necrosis on the liver biopsy</p> Signup and view all the answers

    What is kernicterus?

    <p>A neurologic syndrome resulting in brain damage from bilirubin deposition</p> Signup and view all the answers

    What are early symptoms seen among infants at risk for kernicterus?

    <p>Poor feeding and lethargy</p> Signup and view all the answers

    How can unconjugated hyperbilirubinemia be treated in infants with elevated bilirubin concentrations?

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

    What percentage of affected infants may die within the first week if left untreated for kernicterus?

    <p>70%</p> Signup and view all the answers

    Which of the following neurological signs is NOT associated with kernicterus?

    <p>Skin discoloration</p> Signup and view all the answers

    What is the primary cause of unconjugated hyperbilirubinemia in low-birth-weight infants?

    <p>Breastmilk hyperbilirubinemia</p> Signup and view all the answers

    What is the major risk factor leading to the development of kernicterus in infants?

    <p>(Excess) Bilirubin deposition</p> Signup and view all the answers

    Which type of bilirubin is elevated in Crigler-Najjar Syndrome Type I?

    <p>Indirect bilirubin</p> Signup and view all the answers

    What is the primary cause of severe brain damage leading to death in most patients with Crigler-Najjar Syndrome Type I?

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

    Which type of bilirubin is elevated in Crigler-Najjar Syndrome Type II?

    <p>Indirect bilirubin</p> Signup and view all the answers

    What is the characteristic feature of UDPGT deficiency in Crigler-Najjar Syndrome Type II?

    <p>Presence of a potent UDPGT inhibitor</p> Signup and view all the answers

    What distinguishes Crigler-Najjar Syndrome Type I from Type II in terms of serum bilirubin concentration?

    <p>&gt;20 mg/dl in Type I and 5-20 mg/dl in Type II</p> Signup and view all the answers

    What is the main cause of mild hyperbilirubinemia lasting for the first 2 to 3 weeks of life in Lucey-Driscoll Syndrome?

    <p>Presence of a UDPGT inhibitor</p> Signup and view all the answers

    What contributes to the less severe nature of Crigler-Najjar Syndrome Type II compared to Type I?

    <p>Partial UDPGT deficiency</p> Signup and view all the answers

    What liver enzyme is typically inhibited in Gilbert's syndrome, leading to elevated serum unconjugated bilirubin?

    <p>UGTA1A1</p> Signup and view all the answers

    Which enzyme is released in cases of mitochondrial damage?

    <p>Mitochondrial isoenzyme of AST</p> Signup and view all the answers

    What is the main mechanism of enzyme release due to irreversible damage?

    <p>Leakage of cytoplasmic enzymes</p> Signup and view all the answers

    Which enzyme is increased in cases of obstructive processes?

    <p>Gamma-glutamyl transferase (GGT)</p> Signup and view all the answers

    What is the primary symptom of cirrhosis that generally leads to a poor prognosis?

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

    Which enzyme ratio is typically elevated in cirrhosis and indicates liver dysfunction?

    <p>AST/ALT</p> Signup and view all the answers

    What feature helps differentiate cirrhosis from other liver conditions in terms of symptoms?

    <p>Abdominal swelling</p> Signup and view all the answers

    In cirrhosis, what is a common consequence of reduced liver function indicated by laboratory features before clinical findings?

    <p>Elevated AST/ALT ratio</p> Signup and view all the answers

    What is a key symptom associated with cirrhosis that is often related to decreased liver function?

    <p><strong>Fatigue</strong></p> Signup and view all the answers

    Which of the following symptoms could indicate advanced cirrhosis and complications associated with liver disease?

    <p><strong>Swelling in legs &amp; abdomen</strong></p> Signup and view all the answers

    In acute hepatocellular injury, which enzyme activity is initially higher and then followed by an increase in ALT due to higher activity of the previous enzyme?

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

    Which liver enzyme has a longer half-life and thus remains elevated longer than AST in cases of acute hepatocellular injury?

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

    In acute hepatitis, which enzyme may show a transient increase due to its shorter half-life and return to normal by the time clinical symptoms are observed?

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

    Which liver enzyme appears normal in acute hepatocellular injury but may be minimally elevated in some cases along with an increase in GGT?

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

    Which liver enzyme shows higher activity in hepatocytes and is approximately 7000 times higher in those cells than in plasma during acute hepatocellular injury?

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

    In acute hepatocellular injury, which enzyme's elevation is a hallmark and serves as the best predictor of prognosis?

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

    Which liver enzyme activity is higher than that of AST in most types of liver diseases, except in specific conditions like alcoholic hepatitis and liver neoplasia?

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

    During acute hepatocellular injury, which enzyme is affected due to membrane damage and results in the release of membrane fragments with attached canalicular enzymes?

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

    What is the major acute liver disease that often presents as jaundice?

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

    Which mechanism of cell death involves cell participation in its own demise?

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

    What are the long-term complications of chronic liver injury?

    <p>Cirrhosis and hepatocellular carcinoma</p> Signup and view all the answers

    Which viruses primarily target the liver in hepatic viral infections?

    <p>Viruses A-E &amp;; G</p> Signup and view all the answers

    Which form of cell death involves nuclear chromatin condensation and fragmentation?

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

    What determines the pattern of injury in hepatocellular injury?

    <p>Genetic factors</p> Signup and view all the answers

    What is the primary difference between Crigler-Najjar Syndrome Type I and Type II?

    <p>Type I is treated with liver transplant, while Type II is treated with Phenobarbital.</p> Signup and view all the answers

    Which enzyme deficiency is seen in Gilbert's syndrome that leads to hyperbilirubinemia?

    <p>UDP-glucuronosyltransferase (UDPGT)</p> Signup and view all the answers

    What is the main cause of death in patients with Crigler-Najjar Syndrome Type I?

    <p>Severe brain damage caused by kernicterus</p> Signup and view all the answers

    Which type of bilirubin is elevated in Crigler-Najjar Syndrome Type I?

    <p>Indirect bilirubin</p> Signup and view all the answers

    What is the effect of UDPGT deficiency in Crigler-Najjar Syndrome Type II?

    <p>Partial yet severe deficiency in UDPGT</p> Signup and view all the answers

    What is the major predisposing factor for cirrhosis and hepatocellular carcinoma?

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

    What is a common cause of non-alcoholic steatohepatitis?

    <p>Insulin resistance</p> Signup and view all the answers

    Which liver disease represents a rapidly progressive form of chronic hepatitis?

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

    What is the characteristic type of liver inflammation in acute hepatitis?

    <p>Mainly lymphocytic</p> Signup and view all the answers

    Which condition is characterized by ongoing inflammatory damage to hepatocytes and scarring?

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

    What is a common cause of rare hepatic jaundice?

    <p>Breakdown of hemoglobin from large hematoma</p> Signup and view all the answers

    Which condition is characterized by a decrease or defective production and maturation of RBCs from bone marrow?

    <p>Thalassemia major</p> Signup and view all the answers

    What can lead to an increase in bilirubin levels due to the release of myoglobin?

    <p>Skeletal muscle injury</p> Signup and view all the answers

    Which type of liver disease can be caused by intrinsic liver diseases such as defects in bilirubin metabolism & transport?

    <p>Hepatic jaundice</p> Signup and view all the answers

    What is the primary result of ineffective erythropoiesis in the liver?

    <p>Release of excess bilirubin</p> Signup and view all the answers

    Which enzyme shows higher activity in hepatocytes and is approximately 7000 times higher in those cells than in plasma during acute hepatocellular injury?

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

    What is the main cause of mild hyperbilirubinemia lasting for the first 2 to 3 weeks of life in Gilbert's syndrome?

    <p>Impaired bilirubin uptake</p> Signup and view all the answers

    What distinguishes Acute Hepatitis from Chronic Hepatitis?

    <p>Pattern of liver enzyme elevation</p> Signup and view all the answers

    What is a major predisposing factor for cirrhosis and hepatocellular carcinoma?

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

    Which condition is characterized by irreversible liver damage that cannot easily be reversed?

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

    What is the primary method for treating liver damage caused by alcohol abuse?

    <p>Abstaining from alcohol</p> Signup and view all the answers

    In post-hepatic jaundice, what is the primary cause of biliary obstructive disease?

    <p>Tumors in the biliary tree</p> Signup and view all the answers

    What lab tests are helpful in distinguishing the chronicity of liver injury?

    <p>Liver enzyme patterns</p> Signup and view all the answers

    What is the main consequence of obstructive processes in cases of post-hepatic jaundice?

    <p>Elevated conjugated bilirubin in circulation</p> Signup and view all the answers

    What liver function test is used to assess excretory function in patients with post-hepatic jaundice?

    <p>Bromsulphthalein Test (BSP)</p> Signup and view all the answers

    Which type of jaundice is characterized by blocked bile ducts and progression to portal hypotension?

    <p>Obstructive jaundice</p> Signup and view all the answers

    Which liver function test is most crucial in determining the extent of liver injury in patients?

    <p>Prothrombin time (PT)</p> Signup and view all the answers

    What distinguishes chronic HBV infection from chronic HCV infection?

    <p>Duration of RNA presence</p> Signup and view all the answers

    Which autoimmune hepatitis diagnostic method involves the detection of anti-liver-kidney microsomal antigen type 1?

    <p>Anti-liver-kidney microsomal antigen type 1 detection</p> Signup and view all the answers

    In which condition does fat and inflammation accumulate in the liver despite minimal to no alcohol intake?

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

    What is the primary cause of Gilbert's syndrome?

    <p>Inherited enzyme deficiency</p> Signup and view all the answers

    Which enzyme ratio is typically elevated in cirrhosis indicating liver dysfunction?

    <p>AST/ALT ratio &gt;1</p> Signup and view all the answers

    Which liver enzyme has a longer half-life leading to prolonged elevation in acute hepatocellular injury?

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

    'Cirrhosis' is characterized by which of the following?

    <p><strong>Diffuse fibrosis with nodular regeneration</strong></p> Signup and view all the answers

    Where are canalicular enzymes situated in the cell?

    <p>Bile canaliculi</p> Signup and view all the answers

    In cases of mitochondrial damage, which enzyme is released?

    <p>Mitochondrial isoenzyme of AST</p> Signup and view all the answers

    What is the mechanism of enzyme release mainly due to?

    <p>Irreversible cell membrane damage</p> Signup and view all the answers

    Which enzyme is an example of a cytoplasmic enzyme?

    <p>Aspartate aminotransferase (AST)</p> Signup and view all the answers

    What is used to assess the rate of metabolism?

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

    Which enzymes are typically released as a result of mitochondrial damage?

    <p>Mitochondrial isoenzyme of AST and Alanine aminotransferase (ALT)</p> Signup and view all the answers

    What is the role of cytoplasmic enzymes in hepatocellular injury?

    <p>Released in cases of membrane injury</p> Signup and view all the answers

    Which location in the cell houses enzymes that increase in cases of obstructive processes?

    <p>Bile canaliculi</p> Signup and view all the answers

    Which of the following is a characteristic feature of chronic hepatitis compared to Gilbert Syndrome?

    <p>Presence of bilirubin in urine and anemia</p> Signup and view all the answers

    What is the main cause of jaundice in Gilbert Syndrome?

    <p>Decreased conjugation of bilirubin</p> Signup and view all the answers

    What is the type of bilirubin primarily affected in Gilbert Syndrome?

    <p>Indirect bilirubin</p> Signup and view all the answers

    What causes the reduction in expression of the UGT1A1 gene in Gilbert Syndrome?

    <p>Insertion of an extra TA sequence in UGT1A1 promoter</p> Signup and view all the answers

    What enzyme activity is low in individuals with Gilbert Syndrome compared to normal values?

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

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