Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders--->Liver
Page: 2

Question 6# Print Question

A 42-year-old female presented with anorexia and fatigue. Workup revealed elevated aminotransferases approximately 10 times the upper limit of normal. Immunoglobulin G levels are elevated, and she is found to have positive titers for antinuclear antibodies. Liver biopsy reveals inflammation at the boundaries of the hepatocytes and portal triad. The patient is started on therapy with prednisone.

The addition of which medication would be MOST helpful?

A. Hydrocortisone
B. Tenofovir
C. Azathioprine
D. Warfarin
E. Cefotaxime

Question 7# Print Question

A 62-year-old man with history of ethanol use and hepatic cirrhosis presents with upper gastrointestinal bleeding. Endoscopy reveals multiple varices with signs of recent bleeding. Bands are placed on the varices and the patient is started on an octreotide infusion. His hemoglobin responds well to the single unit of packed red blood cells he was given before endoscopy. Thirty hours later large amount of blood is suctioned out of his nasogastric tube, he becomes hypotensive, and his hemoglobin does not increase despite transfusion of packed red blood cells.

What is the MOST effective additional treatment option? 

A. Fresh frozen plasma transfusion
B. Placing additional bands on varices
C. Permissible hypotension
D. Transjugular intrahepatic portosystemic shunt (TIPS)
E. Increase octreotide infusion

Question 8# Print Question

A 52-year-old female presents with jaundice and right upper quadrant pain. Obstruction of her hepatic vein was found on ultrasonography. After anticoagulation and interventional angioplasty her aminotransferases and bilirubin remain elevated and she is now developing ascites. 

Which treatment option should be considered next?

A. Transjugular intrahepatic portosystemic shunt (TIPS)
B. Liver transplantation
C. Increase therapeutic range of anticoagulation
D. Placement of an inferior vena cava filter
E. Paracentesis

Question 9# Print Question

A patient with no history of chronic liver disease is in the ICU with acute fulminant hepatic failure. Their family is asking you if they will survive. You tell them they are very ill and that based on their liver failure alone the chances they will still be alive in three weeks is around:

A. Less than 10%
B. 33%
C. 70%
D. Greater than 90%

Question 10# Print Question

Which of the following is NOT a risk factor for the development of significant cerebral edema in the setting of liver failure?

A. Hyperacute (0-7 d) presentation
B. Older individuals (>40 y)
C. High-grade hepatic encephalopathy (HE)
D. Serum ammonia >150 µmol/L
E. Concurrent infection

Category: Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders--->Liver
Page: 2 of 2