1. Common hepatitis infections include Hepatitis A, B, and C. Which of these is the least serious?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
Hepatitis A is highly contagious and is transmitted by the fecal-oral route. It usually results from ingestion of contaminated food or water. Most cases are self-limiting and resolve within 4 months.
2. All of the following are true regarding cirrhosis except:
A. It is a chronic disease characterized by destruction and regeneration of liver cells
B. The male:female ratio is 1:2
C. It is especially common in malnourished people over age 50 with chronic alcoholism
D. Many patients die within 5 years of diagnosis
Cirrhosis is a chronic liver disease in which there are both scarring and regeneration. It's the third most common cause of death in people age 45-64 (after heart disease and cancer). It's the end stage of many different diseases, the most common of which is alcoholism (others include infections and Wilson's disease). Complications include: ascites (accumulation of fluid in the peritoneal cavity), coagulopathy (excessive bleeding because the liver is unable to make coagulation factors), portal hypertension, and hepatic encephalopathy (confusion and decreased level of consciousness). Patients also have an increased risk for developing hepatocellular carcinoma.
3. Jaundice is a yellow discoloration of the skin, mucous membranes and eyes. It is caused by an excess of what in the blood?
A. Glucose
B. Creatinine
C. Bilirubin
D. Folate
Easy one.
4. Which of the following predisposes to esophageal varices?
A. Mallory-Weiss syndrome
B. Hemolytic anemia
C. Portal hypertension
D. Barrett esophagus
The portal vein brings blood from the intestine, spleen, pancreas and gallbladder to the liver. This blood passes through the liver sinusoids and then out through the hepatic vein into the general circulation. You can increase your portal blood pressure by either increasing your total blood volume, or by increasing the resistance to flow through the liver (so the blood backs up into the portal system). The latter is the most common mechanism; the most common cause is cirrhosis. Characteristic complications of portal hypertension include esophageal varices, splenomegaly, and ascites.
5. In which part of the GI tract are malignancies most common?
A. Esophagus
B. Stomach
C. Colon
D. Anus
Colon cancer is the third most common type of cancer in both men and women. Most cases are adenocarcinomas arising in benign polyps (which transform over many years into carcinoma). Common symptoms are rectal bleeding, abdominal pain, and weight loss. Regular colonoscopies can prevent the development of colon cancer (you take out whatever polyps are there so they don't get a chance to develop into carcinoma).
6. Gallstones are caused by changes in:
A. Lymph
B. Plasma
C. Bile
D. White blood cells
Most gallstones are formed in the gallbladder. Changes in the concentration of the components of bile (water, bile salts, lecithin, cholesterol) can lead to precipitation from solution and formation of gallstones.
7. The most common site of peptic ulcers is:
A. Stomach
B. Duodenum
C. Jejunum
D. Ileum
About 80% of peptic ulcers occur in the duodenum. The rest occur in the stomach, lower esophagus, or jejunum.
8. Which of the following is a DNA virus?
A. Hepatitis A
B. Hepatitis B
C. Hepatits C
D. Hepatitis D
E. Hepatitis E
Hepatitis B is a double-stranded DNA virus. The rest are single-stranded RNA viruses.
