Liver MCQs for MCCEE, AIPGMEE, PGIEE, JIPMER, FMGE, State PG entrance,

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1. Which of the following is least likely to cause cirrhosis of liver?                                                              

A)     Biliary atresia

B)      Nonalcoholic steatohepatitis

C)      Hepatitis E

D)     Hepatitis C

Ans: C

Hepatitis E infection is self limiting in most cases. It may become chronic in presence of immunodeficiency and rarely leads to cirrhosis of liver.

2. In a case of portal hypertension; porto-systemic shunts develop at all of the following sites EXCEPT:                                                                                                                                                                  

A)     Anal canal

B)      Retroperitoneal space

C)      Anterior abdominal wall

D)     Spleen

Ans: D

Spleen vein drains into the portal vein. Spleen does not have systemic venous drainage, hence there is no porto systemic shunt in the spleen.

3. Which drug is useful in lowering blood pressure in portal system?                                                       

A)     Sodium nitroprusside

B)      Propranolol

C)      Amlodepin

D)     Diltiazam

Ans: B

4. Portal hypertension presenting with intractable ascitis and hepatomegaly is likely to be due to:                                                                                                                                                                                            

A)     Portal vein thrombosis

B)      Budd-chiari syndrome

C)      Alcoholic cirrhosis

D)     Biliary cirrhosis

Ans: B

Occlusion of hepatic vein (Budd- Chiari syndrome) produces abdominal pain, hepatomegaly and ascitis. Portal vein thrombosis causes splenomegaly and porto-systemic shunt. In cirrhosis, the liver is usually shrunken and there is no hepatomegaly.

5. Commonest cause of portal hypertension is:                                                                                                

A)     Cirrhosis of liver

B)      Portal vein thrombosis

C)      Budd chiari syndrome

D)     Spenomegaly

Ans: A

6. In portal hypertension, dilated periumbilical collateral veins are known as:                                      

A)     Asterixix

B)      Caput medusa

C)      Migrating thrombophebitis

D)     Spider angiomata

Ans: B

Asterixix is the flapping tremors of hepatic encephalopathy. Migrating thromboplebitis is non metaststic manifestation of malignancy such as carcimoma of pancreas. Spider angiomata are seen as small lesions with central arterioles, these are due to high estrogen level in cirrhosis of liver.

7. All of the following are features of cirrhosis of liver EXCEPT:                                                                   

A)     Erythema nodosum

B)      Asterixix

C)      Depuytren’s contracture

D)     Gynecomastia

Ans: A

Erythema nodosum is inflammation of fat cells due to immunologic response to infections such as streptococcus, tuberculosis, mycoplasma pneumonia etc. It is not a manifestation of liver cell failure.

8.Late manifestations of cirrhosis of liver include all, EXCEPT:

A)     Portal hypertension

B)      Coagulation disorders

C)      Fatty liver

D)     Hepatorenal syndrome

Ans: C

Fatty liver is early manifestation of liver involvement in alcoholism. It is reversible if alcohol is discontinued. Other options are late manifestations.

9. Commonest type liver cancer is:

A)     Hepatoblastoma

B)      Hepato cellular carcinoma

C)      Hepatic adenoma

D)     Cholangiocarcinoma

Ans: B

Hepatoblastoma is a rare hepatic tumour occurring in children. Cholangiocarcinoma has frequency of 1-2 for 10 cases of hepatocellular carcinoma. Hepatic adenoma is benign tumour.

10.Commonest cause of hepatitis C infection is:

A)     Intravenous recreational drug use

B)      Blood transfusion

C)      Vertical transmission from mother to foetus

D)     Accidental needle stick injury

Ans: A

Infected needle use by intravenous drug users is the commonest cause of transmission of hepatitis C. Blood is tested for Hepatitis C before transfusion, hence incidence of transfusion induced hepatitis C has come down.