Medical Licensing Exam( Mixed Questions 267-489)

*267.Spontaneous bacterial peritonitis:

• appears at the patients with cirrhosis without decompensation

• for initiation of antibiotic therapy, it is mandatory to have a positive microbiological culture sample from ascites liquid

• infected ascites is produced on hematogenous pathway

• the main etiological agent is Staphylococcus aureus

• a high number of neutrophils in the ascites does not represent a proof for antibiotic therapy initiation

*268.Post-systemic encephalopathy treatment:

• administration of enemas and purgatives it’s useful

• stopping the diuretic treatment is not necessary

• protein restriction over 48 hours

• antibiotic therapy with Rifaximin has not a demonstrated efficiency

• IV-line perfusion is not recommended because there is a risk of cerebral edema

*269.Hepatorenal syndrome treatment:

• diuretic therapy is benefic

• volemic refilling should be made with saline solutions

• Noradrenaline administration leads to benefits in extended administration

• Terlipressin administration and human albumin improves the kidney’s function

• angiotensin-converting enzyme inhibitors (IECA) should be administered systematically

*270.Primitive biliary cholangitis (named in the past primitive biliary cirrhosis) is a chronic liver disease characterized through:

• the destruction of the choledochus and secondary cholestasis

• chronic cholestasis associated with biliary lithiasis

• obstruction of the intra- and extrahepatic ducts

• progressive destruction of the interlobular bile ducts

• induced cholestasis by medication which can present a potential toxicity for the liver

*271.Primary sclerosing cholangitis is a chronic cholestatic liver disease described through:

• reversible destruction of the biliary extrahepatic ducts

• Oddi sphincter disfunction with secondary cholestasis

• inflammatory destruction with fibrosis at the biliary intra- but also the extrahepatic ducts

• obstruction due to choledochal lithiasis with secondary chronic cholestasis and the development of a chronic liver disease

• destruction of the small intrahepatic bile ducts

*272)Hereditary hemochromatosis is an inherited disease characterized by:

• Copper deposition in the liver

• excessive iron deposition only in the liver

• excessive iron deposition in various organs, without fibrosis in evolution

• Zinc deposition in various organs

• excessive iron deposition in various organs with fibrosis in evolution and organ failure

*273)Alpha 1 antitrypsin deficiency

• is associated with liver disease and pulmonary emphysema

• hepatic cirrhosis occurs at an age around 30 years old

• it has an etiological treatment

• is a disease which appear at smokers

• clinically manifested disease occurs especially at heterozygotes

*274)The most common etiological factor of liver cirrhosis worldwide is:

• alcohol consumption

• viral infection

• non-alcoholic fatty liver

• hemochromatosis

• Wilson disease

*275)Micronodular cirrhosis is often caused by:

• alcohol

• liver virus B

• liver virus C

• non-alcoholic fatty liver

• autoimmune hepatitis

*276)Relative contraindications of liver transplant includes:

• extended splanchnic vein thrombosis

• the age over 60 years old

• hepatocellular carcinoma with the presence of less than 3 small lesions (<3 cm )

• serum bilirubin over 10 mg/dl

• hepatocellular carcinoma with only one nodule with a dimension under 5 cm