1. Regarding the liver, all are true except
A. ? 15% of the liver is composed of cells other than hepatocytes
B. ? clearance of bacteria, viruses and erythrocytes is done by Kupffer cells
C. ? Ito cells have a role in the uptake and storage of vitamin A
D. ? Vitamin K and folic acids are stored in a huge amount
E. ? hapatic synthesis of urea, endogenous proteins and amino acid release by the liver all are suppressed during fasting
2. The following statements are true except
A. ? low blood urea is seen in many acute and chronic liver diseases
B. ? high blood urea in the context of severe liver damage may indicates gastrointestinal hemorrhage or hepatorenal syndrome
C. ? hyponatremia is very common in severe liver disease and usually multifactorial
D. ? raised gamma GT enzyme level may occur during treatment with carbamazepin
E. ? large increase in serum aminotrnsferases activity with a small rise in alkaline phsophatase activity is in favor of biliary obstruction
3. Drugs that induce hepatic microsomal enzymes, all are true except
A. ? chronic ethanol ingestion
B. ? glucocorticoids
C. ? Grisofulvin
D. ? carbamazepin
E. ? Cimetidin
4. Imaging in liver diseases, all are true except:
A. ? ultrasound of the liver is a rapid, cheap and easy method and usually the first imaging to be done, yet its main limitation is that small focal lesions less than 2 cm will be missed
B. ? color Doppler studies are very useful and used to investigate hepatic veins, portal vein and hepatic artery diseases
C. ? MRI is usually used for pancreaticobiliary diseases rather than parenchymal liver diseases
D. ? outlining the biliary tree can be done by injecting a contrast medium into the biliary tree through the skin or by an endoscopic approach
E. ? plain abdominal radiographs are very helpful in liver diseases
5. Regarding liver biopsy, all are true except
A. ? the patient should be cooperative
B. ? the PT prolongation if present, should be less than 4 seconds above the upper normal control value
C. ? severe COPD is a contraindication
D. ? marked ascites will make the procedure easier
E. ? local skin infection should not be present
6. Regarding the metabolism of bilirubins , all are true except
A. ? every day, about 300 mg of indirect bilirubin is produced
B. ? jaundice will be seen clinically if the total bilirubin exceeds 50 micromole / L
C. ? about 100-200 mg of stercobilinogen is lost in stool
D. ? about 40 mg of urobilinogen is passed outside in urine
E. ? the indirect bilirubin will be conjugated in the endoplasmic reticulum of hepatocytes to be water soluble
7. Causes of indirect hyperbilirubinemia ,all are true except
A. ? B12 deficiency
B. ? Wilson's disease
C. ? Gilbert's syndrome
D. ? Rotor syndrome
E. ...
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