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NursingpharmacyTopic wise MCQs

The Liver, Biliary Tract and Exocrine Pancreas MCQs

1. All are features of extrahepatic biliary atresia (EHBA) except:

  1. A. Ductular proliferation
  2. B. Giant cells
  3. C. Cholestasis
  4. D. Increased hepatic copper

2. Centrilobular necrosis is seen in all except:

  1. A. Yellow fever
  2. B. Ischaemia
  3. C. Chloroform
  4. D. Carbon tetrachloride

3. The form of bilirubin which remains detectable in serum for sufficient time after recovery from the disease is:

  1. A. Biliverdin
  2. B. Unconjugated bilirubin
  3. C. Unbound conjugated bilirubin
  4. D. Delta bilirubin

4. Acute viral hepatitis by the following hepatotropic virus is characterised by fatty change in liver:

  1. A. HAV
  2. B. HBV
  3. C. HCV
  4. D. HDV

5. Extrahepatic cholestasis can be distinguished from intrahepatic cholestasis by the following tests in the former:
A. Bilirubinuria
B. Hypoprothrombinaemia showing improvement following paren-
teral administration of vitamin K

C. Elevated serum alkaline phosphatase
D. Elevated serum bile acids

6. The following conditions have unconjugated hyperbiliru-binaemia except:

  1. A. Dubin-Johnson syndrome
  2. B. Crigler-Najjar syndrome
  3. C. Jaundice of prematurity
  4. D. Gilbert syndrome

7. Kernicterus often develops in the following type of hereditary hyperbilirubinaemia:
A. Gilbert syndrome
B. Crigler-Najjar syndrome, type I
C. Dubin-Johnson syndrome
D. Rotor syndrome

8. Reye’s syndrome is characterised by the following features except:
A. It is a form of hereditary hyperbilirubinaemia
B. There is microvesicular fatty change in hepatocytes
C. Patients have a rapidly downhill course
D. There is decreased activity of mitochondrial enzymes in the liver

9. Hepatic encephalopathy is due to:
A. Hypoxic damage from ischaemia
B. Toxic damage from ammonia
C. Thromboembolic phenomena
D. Hepatopulmonary syndrome

10. Following etiologic factors are implicated in Budd-Chiari syndrome except:

  1. A. Pulmonary embolism
  2. B. Hepatocellular carcinoma
  3. C. Polycythaemia vera
  4. D. Pregnancy

11. Councilman bodies in viral hepatitis are a form of apoptosis seen commonly at the following site:

  1. A. Submassive
  2. B. Centrilobular
  3. C. Midzonal
  4. D. Periportal

12. The following hepatotropic virus is a DNA virus:

  1. A. HAV
  2. B. HBV
  3. C. HCV
  4. D. HEV

13. Chronic carrier state of the following hepatotropic virus infection is observed in the following except:

  1. A. HAV
  2. B. HBV
  3. C. HCV
  4. D. HDV

14. In hepatitis A, life-long protective immunity against reinfection is given by the following class of antibody:

  1. A. IgA
  2. B. IgE
  3. C. IgG
  4. D. IgM

15. Hepatitis B surface antigen (HBsAg) is present as the following structures except:
A. Viral spheres
B. Viral tubules
C. Surface envelope of Dane particle
D. Inner core of Dane particle

16. HBsAg can be demonstrated at the following sites except:
A. Serum of HBV-infected patient
B. Carrier state of HBV
C. Hepatocyte cell membrane in acute stage of illness
D. Hepatocyte cell membrane in chronic hepatitis B

17. In chronic hepatitis B and carrier state of HBV infection, the following antigen is detected on the nuclei of infected hepato- cytes:

  1. A. HBsAg
  2. B. HBeAg
  3. C. HBcAg
  4. D. HBV-DNA

18. In an HDV-infected individual, HDV antigen is detected at the following sites except:

  1. A. Serum in acute illness
  2. B. Serum in carrier state
  3. C. Hepatocyte cell membrane
  4. D. Hepatocyte nuclei

19. Vast majority (more than 90%) of cases of post-transfusion hepatitis are caused by:

  1. A. HBV
  2. B. HCV
  3. C. HDV
  4. D. HGV

20. The most progressive form of chronic hepatitis is caused by:

  1. A. Hepatitis A
  2. B. Hepatitis B
  3. C. Hepatitis C
  4. D. Hepatitis D

21. The following genetic component of HBV is considered respon-
sible for its carcinogenic influence:

  1. A. HBsAg
  2. B. HBeAg
  3. C. HBcAg
  4. D. HBxAg

22. In amoebic liver abscess, trophozoites of E. histolytica are bestdemonstrated at:
A. Necrotic centre of abscess
B. Margin of abscess with viable liver tissue
C. Granulation tissue in the abscess wall
D. Fibrous wall of the abscess

23. The most common site for hydatid cyst is:

  1. A. Liver
  2. B. Lungs
  3. C. Spleen
  4. D. Brain

24. Micronodular cirrhosis includes the following etiologic types except:

  1. A. Laennec’s cirrhosis
  2. B. Nutritional cirrhosis
  3. C. Post-necrotic cirrhosis
  4. D. Portal cirrhosis

25. The major hepatotoxic effect of ethanol is exerted by:
A. Direct hepatotoxicity of ethanol
B. Free radical injury
C. Hepatotoxicity of acetaldehyde
D. Immunologic mechanisms

26. Mallory’s hyalin is seen in the following conditions except:
A. Alcoholic hepatitis
B. Hepatocellular carcinoma
C. Post-necrotic cirrhosis
D. Primary biliary cirrhosis

27. Primary biliary cirrhosis has the following features except:
A. There is elevated cholesterol level in blood
B. It has familial occurrence
C. The condition is more common in men
D. The disease has autoimmune origin

28. Patients of following type of cirrhosis more often may develop hepatocellular carcinoma as a late complication:
A. Biliary cirrhosis
B. Haemochromatosis-induced cirrhosis
C. Cirrhosis in a1 antitrypsin deficiency
D. Cardiac cirrhosis

29. Biochemical abnormalities in Wilson’s disease include the following except:
A. Increased serum ceruloplasmin
B. Increased urinary copper excretion
C. Increased hepatic copper
D. Serum copper low-to-normal-to-high

30. Intrahepatic causes of portal hypertension include the following except:
A. Cirrhosis
B. Budd-Chiari syndrome
C. Portal vein thrombosis
D. Metastatic tumours

31. In developed countries the major risk factor in the pathogenesis of hepatocellular carcinoma is:
A. Long-standing HBV infection
B. Long-standing HCV infection
C. Alcoholic cirrhosis
D. Aflatoxin B1

32. Risk factors implicated in the etiology of cholesterol gallstones include the following except:

  1. A. Family history
  2. B. Obesity
  3. C. Haemolytic anaemia
  4. D. Oral contraceptives

33. The following type of gallstones are generally unassociated with changes in the gallbladder wall:

  1. A. Cholesterol
  2. B. Mixed
  3. C. Combined
  4. D. Pigment

34. The most common site for cancer of the gallbladder is:

  1. A. Fundus
  2. B. Body
  3. C. Neck
  4. D. Cystic duct

35. Pancreatic carcinoma of the following site more often produces obstructive jaundice:

  1. A. Head
  2. B. Body
  3. C. Tail
  4. D. Uncinate process

36. Which of the following hepatotropic viruses is not transmitted bytransfusion?

  1. A. HAV
  2. B. HBV
  3. C. HCV
  4. D. HGV

37. Which of the following hepatotropic viruses does not cause chronic hepatitis?

  1. A. HBV
  2. B. HCV
  3. C. HDV
  4. D. HEV

38. All are true for fibrolamellar HCC except:
A. Found in young
B. Not preceded by cirrhosis
C. Encapsulated
D. Worse prognosis than classic HC

39. A 40 years old woman presents with fever, malaise, signs of jaundice, clay-coloured stools, and high-coloured urine for 10 days. A liver biopsy reveals hepatocyte drop out necrosis, focal inflammation and ballooning degeneration and a few intensely eosinophilic oval bodies are found. What are these microscopic bodies called?

  1. A. Councilman bodies
  2. B. Mallory bodies
  3. C. Psammoma bodies
  4. D. Russell bodies

40. Which of the following abnormalities is most likely to be observed in a known case of hereditary haemochromatosis?

  1. A. Ochronosis
  2. B. Blue sclera
  3. C. Bronze skin
  4. D. Cherry-red pupils

Answer Key
1) = D, 2) = B, 3) = D, 4) = C, 5) = B, 6) = A, 7) = B, 8) = A, 9) = B, 10) = A, 11) = C, 12) = B, 13) = A, 14) = C, 15) = D, 16) = C, 17) = C, 18) = C, 19) = B, 20) = C, 21) = D, 22) = B, 23) = A, 24) = C, 25) = C, 26) = C, 27) = C, 28) = B, 29) = A, 30) = C, 31) = C, 32) = C, 33) = D, 34) = A, 35) = A, 36) = C, 37) = D, 38) = D, 39) = A, 40) = C

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