Topic 22. Pathophysiology of the liver.

1.Flabby contraction of gall bladder was revealed in a woman aged 55 after introducing some of vegetable oil into duodenum. What hormone insufficiency with such state?

A. Gastrin

B. Enterogastrin

C. VIP

D. Pancreozymin

E. Cholecystokinin

2A patient aged 25 has a diagnosis of chronic hepatitis. A patient has lost 10 kg of his body weight for 2 months. Objectively: the skin is dry, desquamative, and pale with yellowish color, small punctate hemorrhages on the skin, stomatorrhagia. The impairment of what hepatic function do petechial hemorrhage and stomatorrhagia prove?

A. Glycogen synthetic

B. ekromogenic

C. Detoxicative

D. Depositing

E. Albumin synthetic

3.On examination bile congestion in the liver and cholelitiasis were revealed in a patient. Point out the main component of cholelitiasis in this state:

A. Calcium bilirubinate

B. Triglycerides

C. Protein

D. Cholesterol

E. Mineral salts

4.What kind of jaundice is characterized by increased amount of direct bilirubin in the blood, appearance of bilirubin in urine, acholic stool?

A. Hemolytic

B. Obstructive

C. Parenchymatous

D. -

E. -

5.Residual nitrogen and urea were determined in the patient’s blood analysis. The amount of urea in the residual nitrogen is considerably reduced. The disease of what organ is characterized by this analysis?

A. Intestine

B. Kidneys

C. Stomach

D. Heart

E. Liver

6.A patient complains of general weakness, boring pain in the abdomen, bad appetite, suspicion on jaundice. Blood serum contains 77.3 mcml/L of total bilirubin and 70.76 mcml/L of conjugative bilirubin. What is the most possible type of jaundice?

A. Mechanical jaundice

B. Acute hepatitis

C. Hepatic cirrhosis

D. Parenchymatous jaundice

E. Hemolytic jaundice

7.In 70’s the scientists determined that the cause of severe jaundice in newborns was the impairment of connection of bilirubin in hepatocytes. What substance is used for the formation of conjugate?

A. Glucoronic acid

B. Pyruvic acid

C. Uric acid

D. Sulphuric acid

E. Lactic acid

8.A man aged 38 with ecteric skin has anemia,enlarged spleen, hyperbilirubinemia, urobilinuria, hypercholic stool. What condition are these changes typical for?

A. Suprahepatogenous jaundice

B. Subhepatogenous jaundice

C. Cellular-hepatogenous jaundice

D. Gilbert’s syndrome

E. Syndrome of hepatic insufficiency

9.It’s determined that a patient with jaundice has increased amount of total bilirubin instead of indirect one (free) in blood plasma,high content of stercolbilin in stool and urine,the level of direct (connected) bilirubin in blood plasma is normal.what kind of jaundice is it?

A. Mechanical

B. Icterus of new borns

C. Parenchymatous (hepatic)

D. Hemolytic

E. Gilbert’s disease

10.In inflammatory process colloidal properties of bile are impaired in gall bladder and this results in the formation of gall stones. What substance crystallization is the main cause of the formation?

A. Cholesterol

B. Urate

C. Chloride

D. Oxalate

E. Phosphate

11.After an accident a completely crashed man’s liver was removed.what disorders do of hepatic absence may cause death during the first hours after operation?

A. Hypoglycemia

B. Intoxication

C. Fall of AP

D. Sharp ascites

E. Hemophilia and hemorrhage

12.rked isoosmotic hyperhydration has developed in a patient with hepatocirrhosis. What is the leading mechanism of dyshydria development?

A. Cardio-vascular insufficiency

B. Growth of wall capillary permeability

C. Rushyer-petrovsky reflex

D. Secondary aldosteronism

E. Hypoproteinemia

13.On the background of pain in the right hypochondrium and yellowness ‘a patient with hepatic cirrhosis has constant dyspeptic disorders in a kind of bitter taste in the mouth, feeling of heaviness in epigatric area, nausea, unstable stool, steatorrhea. What is the main cause of the described disorders?

A. Hypoglycemia

B. Hypocholia and intoxication

C. Increase of stercobilin

D. Hyperbilirubinemia

E. Hypoproteinemia

14.In a severe course of viral hepatitis, a patient has developed adynamia, sleepiness at day time and insomnia at night, inadequate behavior (delirated ideas). There is fetor hepaticus, Kussmaul’s respiration. What kind of metabolism impairment causes these symptoms?

A. Carbohydrate metabolism and hypoglycemia

B. Water and salt metabolism and hyperhydration

C. Fat metabolism

D. Pigmental metabolism and hyperbilirubinemia

E. Nitrogenous metabolism

15.There is increase of indole amount and decrease of indican 1 in the patient’s urine. This indicate the impairment of

A. Filtering function of kidneys

B. Detoxication function of liver

C. Reabsorptive funtion of kidney

D. Albumin synthetic function of liver

E. Secretory function of pancreas

16.Increase of direct and indirect bilirubin is determined in blood of a patient with marked yellowness of sclerae and skin. There is great amount of bilirubin and urobilin in the urine, traces of stercobilin, decrease of stercobilin in stool. Define pathogenic type of jaundice in a patient.

A. Parenchymatous

B. Hemolytic

C. Mechanical

D. By-pass

E. Transmissible

17.A patient admitted to the hospital has clearly marked widened subcutaneous veins in the area of umbilicus (“the head of medusa”). Which of the large venous vessels has the impaired passage?

A. V. renalis

B. V. porta

C. V. iliaca inferior

D. V. mesenterica superior

E. V. mesenterica inferion

18.In coprologic investigation it is determined that stool is colorless; there are drops of neutral fat in it. The most possible case of this is impairment of:

A. Entering the bile into intestine

B. Secretion of intestine juice

C. Acidity of gastric juice

D. Processes of absorption in the intestine

E. Secretion of pancreatic juice

19.A patient had nausea and malaise after taking fatty foodstuffs. Sings of steatorrhea developed in this patient some time later. Content of cholesterol in patient’s blood is 9.2 mmol/L. This condition results from deficiency of:

A. Chylomicrones

B. Triglycerids

C. Bile acids

D. Phospholipids

E. Lipase

20.Low level of albumins and fibrinogen were revealed in the patient’s blood. The decreased activity of what hepatocyte organells cause this phenomenon?

A. Agranular endoplasmic network

B. Mitochondria

C. Granular endoplasmic network

D. Goldgi’s complex

E. Lysosoms.

21.A patient was admitted into a clinic with signs of acute alcohol poisoning. What changes of carbohydrate metabolism are typical for this condition?

A. Gluconeogenesis increases in the liver

B. Glycogen decomposition increases in the liver

C. Aerobic decomposition of glucose increases in the muscles

D. Anaerobic decomposition of glucose predominates in the muscles.

E. The rate of gluconeogenesis decreases in the liver.

22A man aged 54 was admitted into the clinic with complaints of pains in the right hypochondrium vomiting with blood. Objectively: enlargement of hepatic size, varicose of esophagus and stomach, bleeding from them. The functional disorder of what vessel took place?

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