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WorksheetsQuiz on Liver Cirrhosis
Total questions: 50
Worksheet time: 25mins
Who first used the term “cirrhosis” to describe liver disease?
William Harvey
Rene Laennec
Louis Pasteur
Robert Koch
What is the most common cause of liver cirrhosis in Ghana?
HCV
Alcohol
HBV
Fatty Liver Disease
Which of the following describes liver cirrhosis?
Normal liver architecture
Diffuse fibrosis with nodule formation
Focal liver lesions
Acute liver inflammation
Which virus is a common cause of viral hepatitis leading to cirrhosis?
HBV
HIV
Influenza
HSV
What is a common cause of cholestasis-related cirrhosis?
Primary biliary cirrhosis
Hemochromatosis
Wilson’s disease
Alcohol
Which syndrome is characterized by outflow obstruction of hepatic veins?
Budd-Chiari syndrome
Hepatic encephalopathy
Hepatorenal syndrome
Caroli’s disease
The pathophysiology of cirrhosis involves:
Reversible injury only
Progressive and widespread death of liver cells
Focal inflammation only
Acute tissue necrosis
Micronodular cirrhosis has nodules of what size?
< 3 mm
3-10 mm
> 10 mm
> 30 mm
Macronodular cirrhosis typically involves nodules of what size?
< 3 mm
3 mm
> 3 mm
< 1 mm
Which stage of cirrhosis is characterized by the absence of varices and ascites?
Stage 1
Stage 2
Stage 3
Stage 4
Which of the following tests is most useful for suggesting the presence of cirrhosis?
Liver biopsy
Ultrasound
CT scan
MRI
What laboratory test is NOT typically used in liver function tests?
Serum bilirubin
Serum albumin
Serum creatinine
Prothrombin time
Which of these is a common complication of cirrhosis?
Ascites
Myocarditis
Pneumothorax
Meningitis
The most common form of ascites is:
Hemorrhagic ascites
Transudative ascites
Purulent ascites
Chylous ascites
Which two drugs are commonly combined to treat cirrhotic ascites?
Spironolactone and Furosemide
Hydroxyzine and Diazepam
Lasix and Thiazide
Metronidazole and Ciprofloxacin
What is a major concern with diuretic therapy in cirrhotic ascites?
Hypertension
Electrolyte imbalance
Hypoglycemia
Liver failure
Which bacteria are most commonly responsible for spontaneous bacterial peritonitis (SBP)?
Escherichia coli and Klebsiella pneumoniae
Streptococcus pneumoniae and Staphylococcus aureus
Pseudomonas aeruginosa and Enterococcus
Mycobacterium tuberculosis and Treponema pallidum
The diagnosis of SBP is confirmed by:
Elevated serum bilirubin
Positive ascitic fluid bacterial culture and PMN count >250 cells/mm3
Abnormal ultrasound
Liver biopsy
Primary prophylaxis for SBP in high-risk patients includes:
Ciprofloxacin 500 mg daily
Norfloxacin 400 mg twice daily for 7 days
Ceftriaxone IV
Metronidazole
Hepatorenal syndrome is most often precipitated by:
Bacterial infections like SBP
Liver transplantation
Excessive alcohol intake
Portal vein thrombosis
Which medication is NOT recommended for hepatorenal syndrome?
Midodrine
Octreotide
Vasopressin alone
Albumin infusion
What percentage of cirrhotic patients develop gastroesophageal varices?
10-15%
25-35%
50%
70-80%
What is the primary diagnosis tool for portal hypertension-related varices?
Liver biopsy
Endoscopy
Ultrasound
CT scan
For primary prophylaxis of variceal bleeding, what is commonly used in patients with large varices?
Beta-blockers or band ligation
Antibiotics
Diuretics
Steroids
Which drug is used for pharmacologic treatment of acute variceal hemorrhage?
Rifaximin
Lactulose
Octreotide
Amoxicillin
What is the preferred initial management for a patient experiencing acute variceal bleeding?
Surgery
Blood transfusion, IV fluids, antibiotics, and endoscopic band ligation
Liver biopsy
Only antibiotics
Which of the following is a complication of portal hypertension?
Pulmonary fibrosis
Esophageal varices
Myocarditis
Renal failure
What is the typical appearance of ascitic fluid in hepatic hydrothorax?
Exudative
Transudative
Bloody
Purulent
The treatment for hepatic hydrothorax often includes:
Antibiotics
TIPS or thoracentesis
Surgery
Chemotherapy
Hepatopulmonary syndrome involves which of the following features?
Pulmonary embolism
Increased alveolar-arterial gradient and intrapulmonary vascular dilatations
Lung abscess
Asthmatic changes
Which of these is NOT a feature of hepatic encephalopathy?
Asterixis
Hyperreflexia
Jaundice
Altered mental status
What is the main precipitant factor of hepatic encephalopathy?
Hypertension
Gastrointestinal bleeding and infection
Anemia
Pulmonary embolism
Which medication is NOT used in the management of hepatic encephalopathy?
Lactulose
Rifaximin
Amoxicillin
Neomycin
The West Haven Criteria are used to assess:
Liver fibrosis
Severity of hepatic encephalopathy
Degree of ascites
Liver tumor size
Which drug is used as a benzodiazepine receptor antagonist in hepatic encephalopathy?
Flumazenil
Rifaximin
Lactulose
Midodrine
What is the main goal of treatment in hepatic encephalopathy?
Reduce portal pressure
Correct underlying precipitant and reduce ammonia levels
Remove ascitic fluid
Transplant the liver
Which screening test is recommended every 6 months for patients at risk of HCC?
Liver biopsy
Serum AFP and ultrasound
CT scan
MRI
The BCLC staging system for HCC helps determine:
Liver function only
Prognosis and treatment options
Liver fibrosis stage
Cirrhosis severity
Which is considered a curative treatment for small single HCC lesions?
Chemotherapy
Liver resection or transplantation
Antibiotics
Radiotherapy
The Child-Pugh score assesses:
Liver fibrosis stage
Severity of cirrhosis based on clinical and laboratory parameters
Risk of developing HCC
Severity of portal hypertension
The MELD score is primarily used to:
Determine prognosis for liver transplant
Assess degree of ascites
Diagnose cirrhosis
Evaluate for variceal bleeding risk
Liver transplantation is indicated for cirrhotic patients with:
Child-Pugh score 7 or more and specific complications
Only in early-stage cirrhosis
Any patient with hepatitis B
All patients regardless of severity
Which vaccination is recommended for cirrhotic patients?
Hepatitis A and B vaccines
MMR vaccine
Varicella vaccine
Rotavirus vaccine
Screening for HCC should include:
Blood culture and MRI
AFP testing and ultrasonography
Liver biopsy every year
Chest X-ray
Which of these is a future treatment approach under investigation for cirrhosis?
Antifibrotic drugs and stem-cell transplantation
Only diet management
Antibiotics only
No new treatments are under investigation
Which factor does NOT influence the prognosis of cirrhosis?
Underlying cause of liver disease
Success of treatment of the underlying cause
Presence of associated cardiac disease
Development of complications
The defining feature of the natural history of decompensated cirrhosis:
Asymptomatic status
Presence of complications like variceal hemorrhage and ascites
Only mild abnormal liver function tests
Rapid spontaneous recovery
What is the main purpose of surveillance in cirrhotic patients?
Detect early HCC
Detect viral hepatitis
Detect liver enzyme abnormalities
Screen for cardiovascular disease
Which of the following is NOT considered a complication of cirrhosis?
Ascites
Hepatic encephalopathy
Pulmonary embolism
Hepatocellular carcinoma
Which of these is a key goal in the management of cirrhotic patients?
Speed up liver fibrosis
Delay progression and manage complications
Avoid all medications
Only surgical interventions
