GI BLOCK: Week 2 - Liver

1. 1Label this diagram of the visceral (inferior) surface of the liver.

   

   1. Acaudate lobe
   2. Bleft lobe
   3. Cright lobe
   4. Dquadrate lobe
   5. Ehepatic ducts
   6. Ffissure for ligamentum teres
   7. Gfissure for ligamentum venosum
   8. Hportal vein
   9. Icommon bile duct
   10. Jcystic duct
   11. Kporta hepatis
   12. Lfundus
   13. Mbody
   14. Nneck
   15. Ogallbladder
   16. Phepatic artery proper
2. 2Label this diagram of the posterior surface of the liver.

   

   1. Ainferior vena cava
   2. Bcaudate lobe
   3. Cfalciform ligament
   4. Dleft triangular ligament
   5. Egastric
   6. Foesophageal
   7. Gright lobe
   8. Hsuprarenal
   9. Ibare area
   10. Janterior coronary ligament
   11. Kposterior coronary ligament
   12. Lright triangular ligament
   13. Mrenal
   14. Nright lobe
   15. Oneck
   16. Pbody
   17. Qfundus
   18. Rcolic
   19. Sporta hepatis
   20. Tquadrate lobe
3. 3Label the blood supply of the liver.

   

   1. Aleft hepatic artery
   2. Bright hepatic artery
   3. Chepatic artery proper
   4. Dleft gastric artery
   5. Ecystic artery
   6. Fgastroduodenal artery
   7. Gright gastric artery
   8. Habdominal aorta
4. 4How much does a normal liver weigh?

   1. A1500g
   2. B2000g
   3. C1000g
   4. D2500g
   5. E3000g
5. 5Which recesses are associated with the liver?

   1. ASubphrenic recess
   2. BHepatorenal recess
   3. CHepatogastric recess
   4. DSuprarenal recess
   5. EHepatoduodenal recess
   6. FFalciform recess
6. 6What are the 6 ligaments associated with the liver?
   
   1. [blank_start]Falciform ligament[blank_end]
   2. [blank_start]Visceral peritoneum[blank_end]
   3. [blank_start]Hepatogastric ligament[blank_end]
   4. [blank_start]Hepatoduodenal ligament[blank_end]
   5. [blank_start]Right/left triangular ligaments[blank_end] (x2)
   6. [blank_start]Anterior/posterior coronary ligaments[blank_end] (x2)

   1. AFalciform ligament
   2. BVisceral peritoneum
   3. CHepatogastric ligament
   4. DHepatoduodenal ligament
   5. ERight/left triangular ligaments
   6. FAnterior/posterior coronary ligaments
7. 7Which is true about the falciform liver?

   1. AAttaches liver to the anterior abdominal wall (to the level of the umbilicus)
   2. BAttaches liver to the posterior abdominal wall (to the level of the large intestines)
   3. CAttaches liver to the anterior abdominal wall (to the level immediately surrounding the liver)
   4. DAttaches liver to the right lateral abdominal wall
   5. EAttaches the visceral peritoneum to the liver and surrounding structures to prevent detachment
8. 8Which of the following is functionally completely distinct from the left and right lobes of the liver?

   1. AQuadrate lobe
   2. BCaudate lobe
9. 9What percentage of total blood flow into the liver is from the hepatic artery proper?

   1. A30-40%
   2. B20-30%
   3. C50-60%
   4. D60-70%
   5. E70-80%
10. 10Where does the cystic artery branch from?

    1. ARight hepatic artery
    2. BLeft hepatic artery
    3. CHepatic artery proper
    4. DCommon hepatic artery
    5. EGastroduodenal artery

11. 11Label this diagram of the portal vein system.

    

    1. Aleft gastric vein
    2. Bsplenic vein
    3. Cinferior mesenteric vein
    4. Djejunal and ileal veins
    5. Esuperior mesenteric vein
    6. Fmiddle colic vein
    7. Gright colic vein
    8. Hileocolic vein
    9. Iportal vein
12. 12What are the 3 main branches of the portal vein?
    
    1. [blank_start]Splenic vein[blank_end]
    2. [blank_start]Superior mesenteric vein[blank_end]
    3. [blank_start]Inferior mesenteric vein[blank_end]

    1. ASplenic vein
    2. BSuperior mesenteric vein
    3. CInferior mesenteric vein
13. 13Which of the following drain directly into the portal vein? (As opposed to draining into the superior mesenteric v. etc.)

    1. ARight/left gastric veins
    2. BCystic veins
    3. CPara-umbilical veins
    4. DPosterior superior pancreaticoduodenal vein
    5. ELeft colic veins
    6. FAnterior/posterior inferior pancreaticoduodenal veins
    7. GRight gastro-omental vein
    8. HPancreatic vein
14. 14What is the normal blood pressure in the portal vein?

    1. A5-10 mmHg
    2. B10-15 mmHg
    3. C15-20 mmHg
    4. D20-25 mmHg
    5. E25-30 mmHg
15. 15How long is the portal vein?

    1. A8cm
    2. B4cm
    3. C12cm
    4. D16cm
    5. E20cm
16. 16What percentage of total blood flow into the liver comes from the portal vein?

    1. A60-70%
    2. B50-60%
    3. C40-50%
    4. D30-40%
    5. E20-30%
17. 17What is special about the connecting sinusoids of the liver?

    1. AFenestrated endothelium
    2. BLowest pressure venous system in the body
    3. CFlow in opposite direction to the arteries
    4. DContain membrane channels
    5. ETortuous
18. 18What is the lymphatic drainage of the liver?

    1. AHepatic nodes
    2. BCoeliac nodes
    3. CThoracic duct
    4. DSuperior mesenteric nodes
    5. EInferior mesenteric nodes
    6. FPara-aortic duct
19. 19What is the ligamentum teres?

    1. ARemnant of the foetal umbilical vein
    2. BRemnant of the foetal umbilical arteries
    3. CPart of the falciform ligament which attaches the liver to the diaphragm
    4. DPart of the falciform ligament which attaches the liver to the umbilicus
    5. EPart of the falciform ligament which separates the two lobes of the liver
20. 20Describe the 3 different ways of viewing the liver lobule.

    

    1. Aclassic lobule
    2. Bportal lobule
    3. Cliver acinus
21. 21Label this diagram of the classic lobule in the liver.

    

    1. Ainterlobular bile duct
    2. Binterlobular vein
    3. Cinterlobular artery
    4. Dcentral vein
    5. Ehepatocyte
    6. Fhepatic sinusoid
22. 22What is the function of stellate/ito cells in the liver?

    1. AFat storage
    2. BVitamin A storage
    3. CStructural support of hepatocytes
    4. DDigest debris, toxins, bacteria
    5. EBreak down RBCs
    6. FStructural support of fenestrated sinusoids
23. 23Which of the following happen in zone 1 of the liver acinus?

    1. AOxidative metabolism
    2. BGluconeogenesis
    3. CUrea synthesis
    4. DBile/cholesterol formation
    5. EGlycolysis
    6. FLipogenesis/ketogenesis
    7. GDrug metabolism
    8. HGlutamine synthesis
24. 24Which of the following happen in zone 3 of the liver acinus?

    1. AGlycolysis
    2. BLipogenesis/ketogenesis
    3. CDrug metabolism
    4. DGlutamine synthesis
    5. EOxidative metabolism
    6. FGluconeogenesis
    7. GUrea synthesis
    8. HBile/cholesterol formation
25. 25Where are the 5 areas where the portal and systemic circulation meet?
    
    1. [blank_start]Lower end of oesophagus[blank_end]
    2. [blank_start]Umbilicus[blank_end]
    3. [blank_start]Retroperitoneal areas[blank_end]
    4. [blank_start]Bare area of liver[blank_end]
    5. [blank_start]Upper end of anal canal[blank_end]

    1. ALower end of oesophagus
    2. BUmbilicus
    3. CRetroperitoneal areas
    4. DBare area of liver
    5. EUpper end of anal canal
26. 26What are the 5 stages of bilirubin metabolism? Hint: they are the places where each stage happens.
    
    1. [blank_start]Reticulo-endothelial system[blank_end]
    2. [blank_start]Plasma[blank_end]
    3. [blank_start]Liver[blank_end]
    4. [blank_start]Small intestine[blank_end]
    5. [blank_start]Large intestine[blank_end]

    1. AReticulo-endothelial system
    2. BPlasma
    3. CLiver
    4. DSmall intestine
    5. ELarge intestine
27. 27What are the 3 main consequences of portal hypertension?
    
    1. [blank_start]Splenomegaly[blank_end]
    2. [blank_start]Oesophageal varices[blank_end]
    3. [blank_start]Ascites[blank_end]

    1. ASplenomegaly
    2. BOesophageal varices
    3. CAscites
28. 28Outline some causes of portal hypertension.

    

    1. Aportal vein thrombosis
    2. Btrauma
    3. Cschistosomiasis
    4. Ddrugs
    5. Esarcoidosis
    6. Fcirrhosis
    7. Gpolycystic liver disease
    8. Hveno-occlusive disease
    9. Iright sided heart failure
29. 29Describe the pathophysiology of portal hypertension.
    
    1. Increased [blank_start]resistance[blank_end] to blood flow in the portal system
    
    2. Increased [blank_start]resistance[blank_end] to blood flow through the sinusoids of the liver
    
    3. [blank_start]Prehepatic obstruction[blank_end] causing increased resistance:
    a. [blank_start]Obstructive thrombosis[blank_end] (portal vein narrowing)
    b. [blank_start]Increased splenic blood flow[blank_end]
    i. Due to: splenomegaly
    ii. Causes [blank_start]increased blood volume[blank_end] in portal system
    --- Therefore blood cannot pass through the liver [blank_start]quickly[blank_end] enough
    --- Therefore there is a [blank_start]back-up of blood[blank_end] into the portal system
    
    4. [blank_start]Intrahepatic obstruction[blank_end] causing increased resistance:
    a. [blank_start]Cirrhosis[blank_end]
    i. Liver structure is distorted and obstructs blood flow through the sinusoids
    ii. This is due to [blank_start]fibrosis[blank_end] and [blank_start]nodule[blank_end] formation
    iii. This causes increased resistance and a [blank_start]back-up of blood[blank_end] into the portal system
    
    5. [blank_start]Post-hepatic obstruction[blank_end] causing increased resistance:
    a. [blank_start]Hepatic vein outflow obstruction[blank_end]
    b. [blank_start]Right heart failure[blank_end]
    i. Causes back up of blood in the [blank_start]IVC[blank_end]
    ii. This causes back log of blood in the [blank_start]hepatic vein[blank_end]
    iii. This causes back log of blood in the [blank_start]liver[blank_end]
    iv. This causes back log of blood in the [blank_start]portal system[blank_end]

    1. Aresistance
    2. Bresistance
    3. CPrehepatic obstruction
    4. DObstructive thrombosis
    5. EIncreased splenic blood flow
    6. Fincreased blood volume
    7. Gquickly
    8. Hback-up of blood
    9. IIntrahepatic obstruction
    10. Jfibrosis
    11. Knodule
    12. Lback-up of blood
    13. MPost-hepatic obstruction
    14. NHepatic vein outflow obstruction
    15. OCirrhosis
    16. PRight heart failure
    17. QIVC
    18. Rhepatic vein
    19. Sliver
    20. Tportal system
30. 30What are the 4 features of cirrhosis pathophysiology?
    
    1. [blank_start]Ascites[blank_end]
    2. [blank_start]Hepatic encephalopathy[blank_end]
    3. [blank_start]Hepatocellular carcinoma[blank_end]
    4. [blank_start]Portal hypertension[blank_end]

    1. AAscites
    2. BHepatic encephalopathy
    3. CHepatocellular carcinoma
    4. DPortal hypertension
31. 31Why does cirrhosis/portal hypertension cause ascites?
    
    1. [blank_start]Increased hydrostatic pressure[blank_end] in abdomen (due to stagnation of blood in portal system)
    2. [blank_start]Salt and water retention[blank_end] by kidneys
    3. [blank_start]Impaired albumin synthesis[blank_end] by the liver (therefore [blank_start]decreased osmotic pressure[blank_end])

    1. AIncreased hydrostatic pressure
    2. BSalt and water retention
    3. CImpaired albumin synthesis
    4. Ddecreased osmotic pressure
32. 32What are the 3 main features to include in the definition of cirrhosis?
    
    1. [blank_start]Diffuse[blank_end]
    2. [blank_start]Fibrosis[blank_end]
    3. [blank_start]Nodules[blank_end]

    1. ADiffuse
    2. BFibrosis
    3. CNodules
33. 33List the 6 main functions of the liver.
    
    1. [blank_start]Metabolism[blank_end] (e.g. amino acids, carbohydrates, lipids)
    2. [blank_start]Plasma protein and enzyme synthesis[blank_end]
    3. [blank_start]Bile production[blank_end]
    4. [blank_start]Detoxification[blank_end]
    5. [blank_start]Storage[blank_end] (e.g. proteins, glycogen, vitamins, metals)
    6. [blank_start]Immune functions[blank_end]

    1. AMetabolism
    2. BPlasma protein and enzyme synthesis
    3. CBile production
    4. DDetoxification
    5. EStorage
    6. FImmune functions
34. 34What are the 4 processes that are carried out by the liver that are involved in carbohydrate metabolism?
    
    1. [blank_start]Glycolysis[blank_end]
    2. [blank_start]Gluconeogenesis[blank_end]
    3. [blank_start]Glycogenesis[blank_end]
    4. [blank_start]Glycogenolysis[blank_end]

    1. AGlycolysis
    2. BGluconeogenesis
    3. CGlycogenesis
    4. DGlycogenolysis
35. 35What are the 6 processes carried out by the liver that are involved in lipid metabolism?
    
    1. [blank_start]Fatty acid synthesis[blank_end]
    2. [blank_start]Triglyceride synthesis[blank_end]
    3. [blank_start]Beta oxidation[blank_end] of short chain fatty acids
    4. [blank_start]Cholesterol synthesis[blank_end]
    5. [blank_start]Phospholipid synthesis[blank_end]
    6. [blank_start]Lipoprotein synthesis[blank_end]

    1. AFatty acid synthesis
    2. BTriglyceride synthesis
    3. CBeta oxidation
    4. DCholesterol synthesis
    5. EPhospholipid synthesis
    6. FLipoprotein synthesis
36. 36What are the effects of cirrhosis on the liver?
    
    1. [blank_start]Portal hypertension[blank_end] (oesophageal varices, ascites, splenomegaly)
    2. [blank_start]Liver failure[blank_end]
    3. [blank_start]Hepatocellular carcinoma[blank_end]
    4. [blank_start]Hepatic encephalopathy[blank_end]

    1. APortal hypertension
    2. BLiver failure
    3. CHepatocellular carcinoma
    4. DHepatic encephalopathy
37. 37What are the effects of liver failure?
    
    1. [blank_start]Impaired synthesis[blank_end] (e.g. albumin, clotting factors)
    2. [blank_start]Jaundice[blank_end]
    3. [blank_start]Coagulation disorders[blank_end] (due to impaired prothrombin synthesis)
    4. [blank_start]Altered metabolism[blank_end] (e.g. impaired urea synthesis)
    5. [blank_start]Altered drug metabolism[blank_end]
    6. [blank_start]Immune[blank_end], [blank_start]circulatory[blank_end] and [blank_start]endocrine[blank_end] disturbances

    1. AImpaired synthesis
    2. BJaundice
    3. CCoagulation disorders
    4. DAltered metabolism
    5. EAltered drug metabolism
    6. FImmune
    7. Gcirculatory
    8. Hendocrine
38. 38What is Calot's triangle?

    1. AArea where the left and right hepatic ducts converge to form the common hepatic duct
    2. BArea where the common hepatic duct and cystic duct converge to form the common bile duct
    3. CArea where the common bile duct and the main pancreatic duct converge to form the ampulla of Vater
    4. DArea where the hepatic artery proper splits into the left and right hepatic arteries
    5. EArea where the superior mesenteric vein and the splenic vein converge to form the portal vein
39. 39What is the foramen of Winslow?

    1. AOmental foramen - opening between the greater sac and lesser sac
    2. BOpening between greater omentum and peritoneum

Descrição

Undergraduate MBChB Year 2 Quiz sobre GI BLOCK: Week 2 - Liver, criado por Melissa Denker em 17-05-2016.

Autor

Melissa Denker

Idioma

English

Visualizações

2

Etiquetas

mbchb year 2undergraduate

Avaliação

Ainda sem avaliações

Avalie este quiz

Avalie este quiz

Mais sobre Liver