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Question 1
Incorrect
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The liver is the principal site for?
Your Answer: Synthesis of Vit B12
Correct Answer: Storage of iron
Explanation:The liver mainly synthesizes proteins including albumin, globulins and coalgulative factors. Vitamin B12 is taken in via the diet and stored by the liver. Vitamin C is not stored and excessive vitamin C is excreted via urine. Liver is the main site of iron storage, where it is stored in the form of ferritin.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 2
Incorrect
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Where is the lower border of the liver usually found?
Your Answer: 10th rib midclavicular line on right
Correct Answer: 10th rib anterior axillary line on right
Explanation:Assessment of liver margins is important clinically to determine the size of the liver and is done via percussion during the physical examination. The liver typically extends from the fifth intercostal space or 6th rib to the right costal margin in the midclavicular line and the 10th rib on anterior axillary line.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 3
Correct
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Choose the correct statement. The cells of the liver…
Your Answer: Help to maintain the normal blood glucose level.
Explanation:Synthesis of vitamin D3 takes place in both the liver and in the kidneys. The liver is responsible for an intermediate step and final synthesis takes place in the kidneys. Immunoglobulins are manufactured by plasma cells in respective organs where there is antigen exposure. The liver plays a major role in maintaining blood glucose levels by converting excess glucose to glycogen and converting glycogen back to glucose in time of need. Hepatocytes have enzymes that can deactivate steroid hormones.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 4
Correct
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Cytochrome p450 enzymes expressed in hepatocytes serve to?
Your Answer: Facilitate oxidations or hydrolysis of drugs.
Explanation:Cytochrome p 450 are a family of proteins involved in drug metabolism which accounts for about 75% of the total metabolism. Most drugs are deactivated directly or by facilitated excretion from the body.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 5
Correct
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What are the three main structures in the portal triad (portal space)?
Your Answer: Branch of hepatic artery, branch of portal vein, bile ductules
Explanation:A portal triad (also known as portal field, portal area, or portal tract) is a distinctive arrangement in the liver. It is a component of the hepatic lobule. It consists of the following five structures:
- Proper hepatic artery
- Hepatic portal vein
- Common bile duct
- Lymphatic vessels
- Branch of the vagus nerve
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 6
Correct
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Select the correct statement regarding the portal vein.
Your Answer: It drains most of the gastrointestinal tract and the spleen.
Explanation:The portal vein supplies 75% of total blood flow to the liver and enters the liver centrally via the porta hepatis. Portal venous flow increases after meals. The portal vein receives blood from the intestines via the superior and inferior mesenteric veins, from the stomach via gastric veins and from the spleen and pancreas via the splenic vein.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 7
Incorrect
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The hepatic portal vein is a large vessel formed by which of the following veins?
Your Answer: The superior mesenteric vein.
Correct Answer: All of the above
Explanation:The portal vein is usually formed by the confluence of the superior mesenteric and splenic veins and also receives blood from the inferior mesenteric, gastric, and cystic veins.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 8
Correct
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What is the blood supply to the liver?
Your Answer: Hepatic artery and hepatic portal vein
Explanation:The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; approximately half of the liver’s oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 9
Correct
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The endothelium of the sinusoids has the following important function:
Your Answer: Highly fenestrated, large subendothelial spaces, many macrophages
Explanation:Substances absorbed in the intestines reach the liver via the portal vein and contain toxic substances that needs to be detoxified in hepatocytes. Thus, hepatic sinusoids are fenestrated and contain large spaces which allows passage of substances freely. These fenestrations are rich in Kupffer cells which are macrophages.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 10
Correct
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In liver failure there is likely to be?
Your Answer: Raised blood urea
Explanation:Liver failure results in decreased production of all proteins. This causes a decreased albumin: globulin ratio and coagulation dysfunction due to decreased production of coagulation factors. Decreased storage capacity and enzyme reduction affects glucose level regulation and also decreased bile production decreases fat absorption. Liver failure causes blood urea levels to rise due to decreased metabolism and conversion to more soluble forms.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 11
Correct
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In the functional unit of the liver (acinus), the oxygenation…
Your Answer: Reduces towards the centre
Explanation:Cells located close to the portal triad or peripheral zone which consist of arterioles from the hepatic artery are the most oxygenated cells. Cells in the central zone are least oxygenated and mainly receive blood supply from the central vein which is a branch of the hepatic vein.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 12
Incorrect
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The hepatic plates in the liver parenchyma consist of how many cell layers?
Your Answer: 10 – 50 cell layers
Correct Answer: 1 – 2 cell layers
Explanation:Hepatic plates in a hepatic lobule are arranged in 1-2 cell layers.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 13
Correct
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Question 14
Incorrect
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Which of the following portocaval anastomoses can cause problems in preterm infants?
Your Answer: Paraumbilical
Correct Answer: Patent ductus venosus.
Explanation:The ductus venosus is open at the time of the birth and closes during the first week of life in most full-term neonates; however, it may take much longer to close in pre-term neonates. After it closes, the remnant is known as ligamentum venosum. If the ductus venosus fails to occlude after birth, it remains patent (open), and the individual is said to have a patent ductus venosus and thus an intrahepatic portosystemic shunt (PSS).
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 15
Correct
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The conversion of haem to bilirubin is catalysed by which of these enzymes?
Your Answer: Biliverdin reductase
Explanation:Bilirubin is created by the activity of biliverdin reductase on biliverdin, a green tetrapyrrolic bile pigment that is also a product of haem catabolism.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 16
Correct
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The production of bile is increased by: Stimulation of the ____ nerve and the hormone ____.
Your Answer: Vagus, CCK
Explanation:Cholecystokinin is synthesized and secreted by enteroendocrine cells in the duodenum, the first segment of the small intestine, and causes the release of digestive enzymes and bile from the pancreas and gallbladder, respectively. It also acts as a hunger suppressant. Release of CCK is stimulated by monitor peptide released by pancreatic acinar cells as well as CCK-releasing protein, a paracrine factor secreted by enterocytes in the gastrointestinal mucosa. In addition, release of acetylcholine by the parasympathetic nerve fibers of the vagus nerve also stimulate its secretion.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 17
Correct
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The functional unit of the liver is called?
Your Answer: Acini
Explanation:From a metabolic perspective, the functional unit is the hepatic acinus (terminal acinus), each of which is centred on the line connecting two portal triads and extends outwards to the two adjacent central veins. The periportal zone I is nearest to the entering vascular supply and receives the most oxygenated blood, making it least sensitive to ischemic injury while making it very susceptible to viral hepatitis. Conversely, the centrilobular zone III has the poorest oxygenation, and will be most affected during a time of ischemia.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 18
Correct
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Question 19
Correct
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The percentage of blood supplied to the liver by the hepatic artery is?
Your Answer: 25%
Explanation:The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; approximately half of the liver’s oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 20
Correct
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Concerning the functional unit of the liver, which segment is most susceptible to hypoxic damage?
Your Answer: Zone 3
Explanation:From a metabolic perspective, the functional unit is the hepatic acinus (terminal acinus), each of which is centred on the line connecting two portal triads and extends outwards to the two adjacent central veins. The periportal zone I is nearest to the entering vascular supply and receives the most oxygenated blood, making it least sensitive to ischemic injury while making it very susceptible to viral hepatitis. Conversely, the centrilobular zone III has the poorest oxygenation, and will be most affected during a time of ischemia.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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