path test 2

1.

1 point

Pt has conjugated bilirubin levels of 0.8 in blood and 0.4 in urine and unconjugated levels of 0.3. Does this indicate pre hepatic or post hepatic jaundice?

pre

post

neither

2.

1 point

What could cause post hepatic jaundice?

gallstones

portal HTN

hemolytic anemia

GI obstruction

3.

1 point

As a PT, what should you watch out for with patients on dialysis?

fatigue before and after HD

no BP in extremity with fistula

fluid shifts

all of the above

only the first two

4.

1 point

Bilirubin is formed by the breakdown of hemoglobin.

true

false

5.

1 point

Prodromal stage of hepatitis is characterized by fatigue, nausea, fever, weight loss, and fatigue.

true

false

6.

1 point

What is Reynold's pentad?

fever, pain, jaundice, vomiting

Charcot's triad without fever

Charcot's triad + DM + mental status changes

Charcot's triad + hypotension + mental status changes

7.

1 point

PT and PPT of 20s and 50s would indicate normal liver function.

true

false

8.

1 point

Albumin is a protein synthesized in the liver that is responsible for osmotic pressure. Low levels can lead to edema and ascites.

true

false

9.

1 point

What are the symptoms of choledocholithiasis?

N/V, posthepatic jaundice, biliary colic, fever

fever, increased WBC count

RUQ pain

R shoulder pain, fever, anorexia

10.

1 point

Alk phos is a non specific indicator of liver dz with a reference range of 50-85.

true

flase

11.

1 point

How does the liver metabolize carbohydrates?

via gluconeogenesis

via proteineogenesis

carbs are not metabolized in the liver

broken down by buffers

12.

1 point

Portal HTN > 10 mmHg.

true

false

13.

1 point

You are treating a patient with a history of UTIs. The patient C/O increased urination, pain, nausea, and has a fever of 101. You suspect another UTI. Would this UTI likely be in the upper or lower renal system?

upper

lower

impossible to tell

14.

1 point

What does the term neurogenic bladder mean?

bowel obstruction

UTI

loss of voluntary control of voiding

inability to void

15.

1 point

What conditions are contraindicated for a renal transplant?

cancer, AIDS, chronic infection, obesity, substance abuse

musculoskeletal injuries

COPD, asthma

16.

1 point

If a pt received a liver transplant, what would you want to be aware of?

immunosuppression, respiratory issues, edema, ascites

immunosuppression, cardiac issues, edema, ascites

MRSA, GI issues, edema, ascites

immunosuppression, edema, anemia

17.

1 point

Why would CRRT be used?

patient cannot tolerate fluid shifts of HD

infection

C diff precautions

18.

1 point

Fullminant hepatitis can be caused by acetaminophen OD, HAV, HBV, drug reactions, or hepatic ischemia.

true

false

19.

1 point

You are treating a pt with severe liver dz progressing into hepatic encephalopathy. Pt is confused, has muscle rigidity, clonus tone, and nystagmus. Which phase of hepatic encephalopathy would you expect this pt to be in?

Stage I

Stage II

Stage III

Stage IV

20.

1 point

Cirrhosis is characterized by which of the following?

increased total bilirubin, decreased AST/ALT/ALP

decreased total bilirubin, decreased AST/ALT/ALP

increased total bilirubin, increased AST/ALT/ALP

high albumin levels and a low platelet count

21.

1 point

Both conjugated and unconjugated bilirubin are lipid soluble.

true

false

22.

1 point

Hep is is characterized by which of the following?

fecal-oral route, highly contagious, deadly

fecal-oral route, highly contagious, excellent prognosis

fecal-oral route, noncontagious, excellent prognonsis

23.

1 point

Pt has history of ETOH abuse, fatigue, and muscle weakness. Pt C/O abdominal pain and weight loss. What form of hepatitis would most likely be causing this pt's symptoms?

hep c

alcoholic hepatitis

hep g

hep a

24.

1 point

Pt C/O RUQ pain and fever. WBC levels are 14,000. What would you suspect to be the culprit?

cholelithiasis

cholocystitis

choledocholithiasis

25.

1 point

Hep B and C are transmitted via the oral-fecal route.

true

false

26.

1 point

Pt C/O pain after meals, shoulder pain, and upper back pain. What would you suspect is causing this pain?

cholelithiasis

renal dz

MSK injury

ulceritive colitis

27.

1 point

How is ascites treated?

paracentesis, diuretics, restricted salt, blood transfusions

paracentesis, diuretics, restricted fluid, albumin replenishment

paracentesis, diuretics, restricted salt, albumin replenishment

none of the above

28.

1 point

You have a patient who has sudden seemed depressed, isolated socially, has had more falls recently and is not sleeping well dx with Parkinson's disease. What could be the underlying cause of these new sx?

urinary incontinence

pain

undiagnosed depressive disorder

liver disease

29.

1 point

If you drink a lot over the 4th of July break, what enzymes will you use?

rubinoffase

ethanoldehyze

alcohol dehydrogenase and later cytochrome P450

cytochrome P450 and later alcohol dehydrogenase

30.

1 point

How would cholelithiasis be diagnosed?

total bilirubin >3

prehepatic LFT values, ultrasound, MCRP

posthepatic LFT values, ultrasound, MCRP

MRI/X ray

31.

1 point

How is CRF managed medically?

dialysis in conjugation with fluid/electrolyte replacement

blood pressure medication

there is no treatment

only with fluid/electrolyte replacement

32.

1 point

Which type of renal transplant is the most successful?

autograph

living

cadaveric

all of the above

33.

1 point

A patient has just received a renal transplant. She is experiencing a sudden increase in weight and her BUN and Cr levels have also increased. This is most likely the result of?

rejection

an unrelated infection

peripheral edema

34.

1 point

How does the liver's biochemical filter work?

bacteria are broken down by macrophages

cytochrome P450 breaks down toxins via phagocytes and metabolites are absorbed into the GI tract

stellate cells destroy all toxins

cytochrome P450 breaks down toxins via esterification and hydroxiliation and metabolites are secreted into bile and blood and excreted via the GI tract

35.

1 point

What are the normal ranges for ALT and AST respectively?

5-35, 8-20

10-20, 5-10

8-20, 5-35

5-20, 8-35

36.

1 point

What is the function of vitamin D in terms of the liver?

synthesized into calcitrol, which regulates sodium and phosphate levels

synthesized into calcitrol, which regulates calcium and phosphate levels

reacts with electrolytes to remove calcium

none of the above

37.

1 point

Which are examples of obstruction of the upper urinary tract?

UTI

HIV

nephrolithiasis and ureter stenosis or stricture

nephrolithiasis, prostatic hypertrophy

38.

1 point

What important CNS toxin does the liver break down?

ammonia

carbon monoxide

both a and b

neither a or b

39.

1 point

How much bile do we secrete per day?

5-10k mL

70-120 mL

3-4 mL

700-1200 mL

40.

1 point

LDH is elevated with specific liver dz. What is the reference range?

45-90

3.5-5.5

8-20

5-35

41.

1 point

Which of the following is not a symptom of chronic renal failure?

anemia

muscle weakness and wasting

nausea and vomiting

hypertension

42.

1 point

Varicies are a complication of portal HTN. What do varicies cause?

slow chronic bleeding and subsequent anemia

nausea, vomiting

pain in LUQ

DM

43.

1 point

Which vitamin does the liver not store?

A

B12

iron

C

44.

1 point

If a pt has dark urine and light stools, what phase of hepatitis are they in?

prodromal

icteric

recovery