120 Questions
What does abnormal results in the BSP test may indicate?
Defective hepatic blood flow and biliary obstruction
How is the normal liver function determined in the BSP test?
Excretion of 5% or more of the injected dye after 45 minutes
Which of the following substances is NOT metabolized in the liver?
Insulin
What diagnostic tests can be used to assess cirrhosis?
Prothrombin time and partial thromboplastin time
Which of the following is a possible consequence of impaired metabolic liver function?
Decreased serum albumin levels
What do abnormal results in the BSP test suggest?
Impaired hepatic blood flow and biliary obstruction
Which condition is characterized by diffuse fibrosis with nodular regeneration in the liver?
Cirrhosis
Which type of bilirubin is increased in Gilbert's syndrome?
Unconjugated bilirubin
Which condition is associated with a rise in prothrombin time and a decrease in platelet count?
Cirrhosis
Which liver function test ratio is typically elevated in cirrhosis?
AST/ALT ratio >1
Which condition presents with intense itching, swelling in legs & abdomen, and bleeding from the GI tract?
Cirrhosis
What is the primary symptom of Dubin-Johnson syndrome?
Jaundice
'End stage of scar formation and regeneration in chronic liver injury' describes which liver condition?
Cirrhosis
What is the main characteristic of chronic hepatitis?
Elevated cytosolic enzymes
Which virus is NOT typically associated with causing hepatic viral infection?
Hepatitis B virus
What is a major predisposing factor for cirrhosis and hepatocellular carcinoma?
Chronic hepatitis
In non-alcoholic steatohepatitis, fatty liver disease results from:
Insulin resistance
Which factor is NOT associated with the development of non-alcoholic steatohepatitis?
Wilson’s disease
What distinguishes acute hepatitis from chronic hepatitis?
Inflammation persists for ≥6 months
Which component is NOT a major component of chronic hepatitis?
Liver regeneration
In viral hepatitis, what enzymes show marked elevations, often 8-50 times the upper limit?
ALT/AST
Which type of hepatitis may show a transient increase in lactate dehydrogenase?
Acute hepatitis
What is a characteristic of drug-induced hepatitis in terms of ALT and AST activities?
Gradual rise in aminotransferases
Which enzyme may be increased in some cases of acute hepatitis in addition to GGT?
Alkaline phosphatase
What type of hepatitis is identified by various viruses including CMV and EBV?
Viral hepatitis
Which form of drug-induced hepatitis is characterized by an increase in ALP?
Cholestatic form
What enzyme typically peaks before the peak of bilirubin in viral hepatitis?
Aminotransferases
What is the structure of Alpha-fetoprotein (AFP) similar to?
Albumin
Which liver disease is commonly associated with Anti-Mitochondrial Antibody detection?
Primary Biliary Cirrhosis
What is the main diagnostic importance of Alpha-fetoprotein (AFP) in liver health screenings?
Screening for Hepatocellular Carcinoma (HCC)
Which enzyme has the longest half-life among the ones listed?
Mitochondrial AST
Which test is NOT commonly used for detecting liver autoimmune diseases?
ALP test
What is the role of Anti-Mitochondrial Antibodies in autoimmune liver diseases?
Destroying intrahepatic ducts
Which liver disease is characterized by destruction of both intra and extrahepatic bile ducts?
Primary Sclerosing Cholangitis
What is a common symptom associated with Ischemic Hepatitis?
'Mid zone' necrosis on the liver biopsy
What is kernicterus?
A neurologic syndrome resulting in brain damage from bilirubin deposition
What are early symptoms seen among infants at risk for kernicterus?
Poor feeding and lethargy
How can unconjugated hyperbilirubinemia be treated in infants with elevated bilirubin concentrations?
Phototherapy
What percentage of affected infants may die within the first week if left untreated for kernicterus?
70%
Which of the following neurological signs is NOT associated with kernicterus?
Skin discoloration
What is the primary cause of unconjugated hyperbilirubinemia in low-birth-weight infants?
Breastmilk hyperbilirubinemia
What is the major risk factor leading to the development of kernicterus in infants?
(Excess) Bilirubin deposition
Which type of bilirubin is elevated in Crigler-Najjar Syndrome Type I?
Indirect bilirubin
What is the primary cause of severe brain damage leading to death in most patients with Crigler-Najjar Syndrome Type I?
Kernicterus
Which type of bilirubin is elevated in Crigler-Najjar Syndrome Type II?
Indirect bilirubin
What is the characteristic feature of UDPGT deficiency in Crigler-Najjar Syndrome Type II?
Presence of a potent UDPGT inhibitor
What distinguishes Crigler-Najjar Syndrome Type I from Type II in terms of serum bilirubin concentration?
>20 mg/dl in Type I and 5-20 mg/dl in Type II
What is the main cause of mild hyperbilirubinemia lasting for the first 2 to 3 weeks of life in Lucey-Driscoll Syndrome?
Presence of a UDPGT inhibitor
What contributes to the less severe nature of Crigler-Najjar Syndrome Type II compared to Type I?
Partial UDPGT deficiency
What liver enzyme is typically inhibited in Gilbert's syndrome, leading to elevated serum unconjugated bilirubin?
UGTA1A1
Which enzyme is released in cases of mitochondrial damage?
Mitochondrial isoenzyme of AST
What is the main mechanism of enzyme release due to irreversible damage?
Leakage of cytoplasmic enzymes
Which enzyme is increased in cases of obstructive processes?
Gamma-glutamyl transferase (GGT)
What is the primary symptom of cirrhosis that generally leads to a poor prognosis?
Jaundice
Which enzyme ratio is typically elevated in cirrhosis and indicates liver dysfunction?
AST/ALT
What feature helps differentiate cirrhosis from other liver conditions in terms of symptoms?
Abdominal swelling
In cirrhosis, what is a common consequence of reduced liver function indicated by laboratory features before clinical findings?
Elevated AST/ALT ratio
What is a key symptom associated with cirrhosis that is often related to decreased liver function?
Fatigue
Which of the following symptoms could indicate advanced cirrhosis and complications associated with liver disease?
Swelling in legs & abdomen
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?
AST
Which liver enzyme has a longer half-life and thus remains elevated longer than AST in cases of acute hepatocellular injury?
ALT
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?
LDH
Which liver enzyme appears normal in acute hepatocellular injury but may be minimally elevated in some cases along with an increase in GGT?
ALP
Which liver enzyme shows higher activity in hepatocytes and is approximately 7000 times higher in those cells than in plasma during acute hepatocellular injury?
AST
In acute hepatocellular injury, which enzyme's elevation is a hallmark and serves as the best predictor of prognosis?
ALT
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?
ALT
During acute hepatocellular injury, which enzyme is affected due to membrane damage and results in the release of membrane fragments with attached canalicular enzymes?
GGT
What is the major acute liver disease that often presents as jaundice?
Acute hepatitis
Which mechanism of cell death involves cell participation in its own demise?
Apoptosis
What are the long-term complications of chronic liver injury?
Cirrhosis and hepatocellular carcinoma
Which viruses primarily target the liver in hepatic viral infections?
Viruses A-E &; G
Which form of cell death involves nuclear chromatin condensation and fragmentation?
Apoptosis
What determines the pattern of injury in hepatocellular injury?
Genetic factors
What is the primary difference between Crigler-Najjar Syndrome Type I and Type II?
Type I is treated with liver transplant, while Type II is treated with Phenobarbital.
Which enzyme deficiency is seen in Gilbert's syndrome that leads to hyperbilirubinemia?
UDP-glucuronosyltransferase (UDPGT)
What is the main cause of death in patients with Crigler-Najjar Syndrome Type I?
Severe brain damage caused by kernicterus
Which type of bilirubin is elevated in Crigler-Najjar Syndrome Type I?
Indirect bilirubin
What is the effect of UDPGT deficiency in Crigler-Najjar Syndrome Type II?
Partial yet severe deficiency in UDPGT
What is the major predisposing factor for cirrhosis and hepatocellular carcinoma?
Chronic Hepatitis
What is a common cause of non-alcoholic steatohepatitis?
Insulin resistance
Which liver disease represents a rapidly progressive form of chronic hepatitis?
Autoimmune hepatitis
What is the characteristic type of liver inflammation in acute hepatitis?
Mainly lymphocytic
Which condition is characterized by ongoing inflammatory damage to hepatocytes and scarring?
Cirrhosis
What is a common cause of rare hepatic jaundice?
Breakdown of hemoglobin from large hematoma
Which condition is characterized by a decrease or defective production and maturation of RBCs from bone marrow?
Thalassemia major
What can lead to an increase in bilirubin levels due to the release of myoglobin?
Skeletal muscle injury
Which type of liver disease can be caused by intrinsic liver diseases such as defects in bilirubin metabolism & transport?
Hepatic jaundice
What is the primary result of ineffective erythropoiesis in the liver?
Release of excess bilirubin
Which enzyme shows higher activity in hepatocytes and is approximately 7000 times higher in those cells than in plasma during acute hepatocellular injury?
AST
What is the main cause of mild hyperbilirubinemia lasting for the first 2 to 3 weeks of life in Gilbert's syndrome?
Impaired bilirubin uptake
What distinguishes Acute Hepatitis from Chronic Hepatitis?
Pattern of liver enzyme elevation
What is a major predisposing factor for cirrhosis and hepatocellular carcinoma?
Chronic Hepatitis
Which condition is characterized by irreversible liver damage that cannot easily be reversed?
Cirrhosis
What is the primary method for treating liver damage caused by alcohol abuse?
Abstaining from alcohol
In post-hepatic jaundice, what is the primary cause of biliary obstructive disease?
Tumors in the biliary tree
What lab tests are helpful in distinguishing the chronicity of liver injury?
Liver enzyme patterns
What is the main consequence of obstructive processes in cases of post-hepatic jaundice?
Elevated conjugated bilirubin in circulation
What liver function test is used to assess excretory function in patients with post-hepatic jaundice?
Bromsulphthalein Test (BSP)
Which type of jaundice is characterized by blocked bile ducts and progression to portal hypotension?
Obstructive jaundice
Which liver function test is most crucial in determining the extent of liver injury in patients?
Prothrombin time (PT)
What distinguishes chronic HBV infection from chronic HCV infection?
Duration of RNA presence
Which autoimmune hepatitis diagnostic method involves the detection of anti-liver-kidney microsomal antigen type 1?
Anti-liver-kidney microsomal antigen type 1 detection
In which condition does fat and inflammation accumulate in the liver despite minimal to no alcohol intake?
Non-alcoholic fatty liver disease & NASH
What is the primary cause of Gilbert's syndrome?
Inherited enzyme deficiency
Which enzyme ratio is typically elevated in cirrhosis indicating liver dysfunction?
AST/ALT ratio >1
Which liver enzyme has a longer half-life leading to prolonged elevation in acute hepatocellular injury?
ALT
'Cirrhosis' is characterized by which of the following?
Diffuse fibrosis with nodular regeneration
Where are canalicular enzymes situated in the cell?
Bile canaliculi
In cases of mitochondrial damage, which enzyme is released?
Mitochondrial isoenzyme of AST
What is the mechanism of enzyme release mainly due to?
Irreversible cell membrane damage
Which enzyme is an example of a cytoplasmic enzyme?
Aspartate aminotransferase (AST)
What is used to assess the rate of metabolism?
Lidocaine
Which enzymes are typically released as a result of mitochondrial damage?
Mitochondrial isoenzyme of AST and Alanine aminotransferase (ALT)
What is the role of cytoplasmic enzymes in hepatocellular injury?
Released in cases of membrane injury
Which location in the cell houses enzymes that increase in cases of obstructive processes?
Bile canaliculi
Which of the following is a characteristic feature of chronic hepatitis compared to Gilbert Syndrome?
Presence of bilirubin in urine and anemia
What is the main cause of jaundice in Gilbert Syndrome?
Decreased conjugation of bilirubin
What is the type of bilirubin primarily affected in Gilbert Syndrome?
Indirect bilirubin
What causes the reduction in expression of the UGT1A1 gene in Gilbert Syndrome?
Insertion of an extra TA sequence in UGT1A1 promoter
What enzyme activity is low in individuals with Gilbert Syndrome compared to normal values?
UDPGT
Test your knowledge on autoantibodies such as antinuclear antibody, antismooth muscle antibody, anti-liver kidney microsomal antigen type 1, and anti-soluble liver antigen, as well as liver function alterations including hepatocellular diseases, changes in bilirubin concentration in jaundice, and different types of jaundice.
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