Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
24 Hepatology MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 8 practice questions
- Liver transplantation
- Liver failure and ascites
- Liver disease
- Cholestatic and metabolic liver disease
- Liver infection and NAFLD
- Cirrhosis
- Viral hepatitis
- Biliary tumours
1. An older man has obstructive jaundice with raised serum IgG4 and autoimmune pancreatitis, and another has ferritin 1800 with transferrin saturation 65%. Which treatments fit?
- AGlucocorticoids for IgG4 cholangitis, and HFE testing then weekly venesection to ferritin under 50 for haemochromatosis
- BSurgery, and steroids
- CTransplantation, and antibiotics
- DUrsodeoxycholic acid, and chelation
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A. Glucocorticoids for IgG4 cholangitis, and HFE testing then weekly venesection to ferritin under 50 for haemochromatosis IgG4 disease responds well to glucocorticoids; hepatocellular carcinoma is the main cause of death in cirrhotic haemochromatosis.
2. A woman has jaundice, weight loss, a palpable mass and calcified gallbladder wall, and a man from northern Thailand has cholangiocarcinoma. Which statements are correct?
- ACholangiocarcinoma, and hepatitis B
- BHepatitis, and alcohol
- CGallbladder carcinoma with death typically within a year of symptoms, and chronic Clonorchis sinensis liver fluke infection
- DCholecystitis, and gallstones
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C. Gallbladder carcinoma with death typically within a year of symptoms, and chronic Clonorchis sinensis liver fluke infection Gallstones are present in 70-80% of gallbladder cancers; CCA also associates with PSC, Caroli's disease and choledochal cysts.
3. A pregnant woman has liver failure with microvesicular steatosis, and a patient with ulcerative colitis has multifocal strictures on cholangiography. Which statements are correct?
- AViral hepatitis explains the first, and MRI is annual
- BAutoimmunity explains the first, and CA19-9 is routine
- CDefective mitochondrial beta-oxidation explains the first, and primary sclerosing cholangitis needs annual gallbladder ultrasound and colonoscopy
- DAlcohol explains the first, and cholangiocarcinoma screening is routine
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C. Defective mitochondrial beta-oxidation explains the first, and primary sclerosing cholangitis needs annual gallbladder ultrasound and colonoscopy Acute fatty liver arises from defective mitochondrial beta-oxidation; cholangiocarcinoma is the commonest cause of death in PSC but routine screening is not established.
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